Which sociodemographic and pathway to care factors influence the wait time for early intervention for psychosis? A mental health electronic health records analysis in South London

Aim: In 2016, the Access and Waiting Time Standard (AWTS) was introduced in England, UK, outlining that people with first-episode psychosis should receive treatment from an early intervention for psychosis (EIP) service within 2 weeks. We examined sociodemographic, pathways to care (PtC), and clinical factors associated with EIP service wait time.  

Method: We collected de-identified data from a large mental health provider in South London, UK. We included patients referred and accepted to EIP services as inpatient or community contacts between 1 May 2016 and 30 April 2019, providing 3 years of data from the introduction of AWTS. Descriptive statistics and multivariable linear regression were performed.  

Results: A total of 1806 patients were identified with a mean age of 30 (SD: 10.7) years, of whom 86.3% (n = 1559) accessed community EIP and 13.7% (n = 247) accessed inpatient EIP; of these, 26.7% were not seen within 2 weeks. Community EIP patients waited longer adj.β = 2.21 days (95% CI: 2.05–2.37) compared with inpatient EIP patients, and being older was associated with longer wait time. Conversely, a shorter wait time was associated with A&E [adj.β = −0.22 days (95% CI: −0.36, −0.10)] and ‘other’ [adj.β = −0.21 days (95% CI: −0.36, −0.03)] PtC characteristics. White non-British and South Asian patients had shorter wait times compared with White British patients; however, this difference diminished after adjusting for PtC and clinical factors.  

Conclusions: Our findings indicate that individual factors, PtC, and mode of contact influence wait time for EIP services. More than a quarter of patients were not seen within 2 weeks, indicating that targeted support in community EIP services is needed to meet clinical guidelines.