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Gender gap in psychosis treatment

ยท Recording for patients with psychosis needs to improve

*Regional figures are available

*HSCIC must be cited as the source of these figures

September 26, 2014

Men who display symptoms of psychosis are recorded as being untreated for fifty per cent longer than women, based on those where information recorded. This is according to figures published today by the Health and Social Care Information Centre1.

The figures show that, based on the information recorded2, after the onset of visible psychosis symptoms (the emergent psychosis stage)3 the median time it takes for males to receive a prescription is 4.5 weeks4, compared to 3.0 weeks for women.

The special report into Duration of Untreated Psychosis (DUP) focuses on adults who are referred to NHS funded Early Intervention in Psychosis Services (EIS), which are the recommended way5 to deal with psychosis in its early stages. The report is published using figures from the Mental Health Minimum Data Set (MHMDS), which collects information about people accessing secondary mental health services6 in England.

In 2013/14 there were 28,115 people in contact with EIS, with all of these people experiencing psychotic symptoms. Of these, 1,497 people (5.3 per cent) had sufficient information recorded to allow us to calculate DUP7. Providers should record information about DUP where they provide EIS services although not all providers do. However, the number of people with enough information recorded to calculate DUP has risen from 629 recorded cases in 2011/12 to 1,497 recorded cases in 2013/14.

The report also shows that more men had sufficient information8 recorded to calculate DUP than women. In 2013/14 963 men had sufficient information recorded as compared to 534 women.

There are also variations in the length of time between the emergent psychosis date and prescription date between people of different ethnicities. The recorded information shows that median DUP for the black or black British ethnic group was longer than for other ethnic groups. For this group the median was 5.5 weeks, compared to 3.5 weeks for the white ethnic group and 4.0 weeks for the Asian ethnic group.

Kingsley Manning, Chair of the Health and Social Care Information Centre said: "The recording of information about psychosis in the NHS needs to improve. Better data will allow care organisations to gain a clearer picture about how these services are running and how the situation is changing.

"Where information is recorded, it shows that there are wide variations in the time it takes for people with psychosis to receive treatment and should lead to questions for the health service about why these differences occur; whether some groups take longer to initially seek treatment for their symptoms or due to other factors."

The full report is available at


Notes to editors

1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 220 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.

2. The number of people with DUP information is lower than would be expected, as we would expect everyone in contact with EIS to have some of this information recorded. HSCIC is working closely with providers to understand the barriers to the recording and submission of this data.

3. This is the date the person reports they first experienced a positive psychotic symptom (i.e. delusion, hallucination, or thought disorder), regardless of its duration.

4. For each record, Duration of Untreated Psychosis was calculated in days and rounded into weeks as follows: 0-1 days were rounded down, 2-5 days were counted as 0.5 weeks, and 6-7 days were rounded up.

5. The National Institute for Health and Care Excellence (NICE) states: Early intervention in psychosis services should be accessible to all people with a first episode or first presentation of psychosis, irrespective of the person's age or the duration of untreated psychosis (Psychosis and schizophrenia in adults: treatment and management CG178 (2014) - NICE)

6. Secondary mental health services are services provided in a hospital after a person has been referred by another healthcare professional, such as a GP

7. 2,300 people in 2013/14 had any information recorded about DUP, but only 1,497 had both psychosis start dates and treatment start dates recorded. This may be perfectly reasonable as in some cases a person will not have started treatment yet.

8. To calculate DUP for a person, there must be both a psychosis start date and a treatment date recorded in the MHMDS. Not all records have both fields populated, thus DUP cannot be calculated for those people where only a start date or only a treatment date recorded.

9. For media enquiries or interview requests please contact the press office on or 0300 3033 888 - please note our change in media line number

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