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General Practice Recruitment for People at Risk of Schizophrenia: The Buckingham Experience

Objective: The process of detecting people at high risk of schizophrenia from a community sample is a major challenge for prevention of psychotic disorders. The aim of this paper is to describe earlydetection procedures that can be implemented in primary care settings. Methods: A selected literature review is supplemented by experiences and data obtained during the Buckingham Integrated Mental Health Care Project. Results: General medical practitioners have been favoured as the agents most likelyto prove helpful in detecting the key riskfactors thatpredict the onsetof schizophrenic disorders, as wellas in recognising the earliest signsand symptoms of these conditions. However, the practical problems of screening for multiple and subtle risk factors in general practice aresubstantial, andgeneral practitioners (GPs) often have difficulty recognising the earliest signs of a psychotic episode. A range of strategies to assistGPs detect earlysignsof psychosis in their patients are considered. Conclusions: It is feasible to implement primary care setting early detection procedures for people at riskof schizophrenia. Implementation is aided by the use of a briefscreening questionnaire, training sessions andcasesupervision; and increased collaboration with mental health services and othercommunity agencies.