Join my mission to improve health care for people with psychosis
Norman Young has spent 25 years striving to improve care for mentally ill people, and enjoyed a fascinating career in the process
Since I started my mental health nurse training in 1991, it has been my mission to improve the health and wellbeing of people with psychosis, a condition that affects around 1% of the UK’s adult population.
In my role as nurse consultant and associate lecturer, I work with people who experience psychosis, providing or prescribing treatments and care, and carrying out consultations with staff. I also work on service development, research and teaching.
A recent case involved a young woman with psychosis who hears voices. They cause her distress and impairment and she has to take time off work. My goals were to reduce the distress caused by these voices and unusual thoughts, and help the patient return to her job. I met with her family to help improve their knowledge of her condition, and to help them develop skills to reduce the burden of caring.
From April 2017, NHS England aims to address this by setting a standard two-week maximum for the time between recognition of psychosis and starting treatment. A standard of 28 days applies to mental health referrals in Wales.
I am leading new developments in this area in Wales, after the government allocated £800,000 in May for better services for young people with psychosis.
The preferred model for early intervention in psychosis is care delivered by youth-friendly specialist teams who engage with people who may be developing or having first-episode psychosis.
The teams help the person and their family to understand their mental health problems and address their symptoms, while keeping a focus on participation in the community and education or employment.
But, despite ‘protected’ budgets, decreased funding for mental health services means that some early intervention teams have been dismantled, and their function transferred to generic community teams. In areas without specialist services, it falls to these community teams to provide care and treatment.
In Cardiff, I work on developing and sustaining the care pathway for first-episode psychosis across seven teams, supporting them through continued service improvement, consultation, supervision, education and training.
Nurse consultants and advanced nurse practitioners give nursing a necessary voice on many national boards and guideline development groups. Through the RCN mental health forum, I worked on standards in adult inpatient wards, and I was also a committee member on the National Institute for Health and Care Excellence 2014 guidelines on schizophrenia and psychosis.
My commitment to improving services continues, as chair of the Accreditation for Community Mental Health Services, a new set of standards from the Royal College of Psychiatrists, and as part of the Q initiative, a new national development in quality improvement led by the Health Foundation, which aims to connect people across the UK who are skilled in improvement.