blindNICE has issued a new quality standard to help adults with psychosis and schizophrenia have a positive experience of mental health services and ensure they receive the support they need.

Psychosis and schizophrenia cover a range of disorders in which a person’s thoughts, mood and behaviour are significantly altered. Each person will have a unique combination of symptoms and experiences. They can include hallucinations, delusions, social withdrawal or self-neglect.

Recent figures showed that up until 2009, there were about 17,000 new cases of psychosis and 8,000 new cases of schizophrenia in England each year.

People with severe mental illness such as schizophrenia often die 15-20 years earlier than people without a severe mental illness. There may be several reasons why. For instance, many people with psychosis and schizophrenia will often have other health problems such as heart disease and diabetes, that can be made worse by antipsychotic drugs.

The latest service audit showed an increase in the number of people with schizophrenia receiving physical health checks; however this was still only a third of service users. The quality standard includes a statement to continue to drive improvements, calling for regular health checks to be prioritised. Healthcare professionals should monitor weight, waist and blood pressure measurements with results to be shared with a person’s GP and mental health team.

In 2014, only 7% of people using mental health services were in paid employment. The latest audit of schizophrenia services also found that less than half (48%) of those who wanted to find work felt they got any help job hunting4. The quality standard stresses the need for structured employment programmes to be made available to people with psychosis and schizophrenia who would like to find work.

Other priorities in the quality standard cover the treatment of people with psychosis and schizophrenia, as well as support for their family and carers including:
  • Ensuring people who have a first episode of psychosis start treatment in an early intervention in psychosis service within two weeks of being referred.
  • Offering cognitive behavioural therapy for psychosis to help people with psychosis and schizophrenia cope with their symptoms.
  • Providing education and support programmes for carers.
Professor Gillian Leng, deputy chief executive and director of health and social care for NICE, said: “Psychosis and the specific diagnosis of schizophrenia are serious mental illnesses that have debilitating symptoms and can affect all aspects of a person’s life. Many people with severe mental illness will also suffer from additional health problems, like heart disease and diabetes, which can significantly affect how long they live. Other symptoms such as a lack of drive or social withdrawal, means they might also struggle to contribute to society. We are seeing improvements in mental health services but there is still some way to go before we can be sure that all people with psychosis and schizophrenia are getting high-quality care. There are certain areas such as offering health checks, providing access to psychological therapies and employment support, where we know more still needs to be done to drive improvements in care."