Jockey Club Early Psychosis (JCEP) Project

Psychotic disorders including schizophrenia are an important area in psychiatry as well as medical healthcare in general. They rank among the top 10 leading causes of disability-adjusted life-years (DALYs) and are the third most disabling condition worldwide, incurring substantial long-term burdens to the individual, their family and the society. To improve the management and outcome of patients with psychosis, the World Health Organization (WHO) and International Early Psychosis Association jointly issued the Early Psychosis Declaration, advocating the development of early intervention programmes for psychosis.

bannerFrom left) Professor Char-Nie Chen, Professor Robert Miller, Mr Shane Solomon, Dr. Donald Li, Dr York Chow, Professor Lap-Chee Tsui, Professor Eric Chen, and Ms Maggie Chan.

In Hong Kong, while some ground work on early psychosis has been done by the Psychotic Disorders Study and Intervention (PSI) Programme in our Department, and pilot early intervention service has been started in the 15- to 25-year-olds by the Hospital Authority’s Early Assessment Service for Young persons with psychosis (EASY) Programme, room for further development exists. Gaps were noted in our knowledge about the optimal intervention period and model, public education and professional training, and service coverage in the local scene.

The Department has recently been awarded a grant of HK$68.82 million by the Hong Kong Jockey Club Charities Trust for the implementation of a 5-year project to meet these unfulfilled needs. The Jockey Club Early Psychosis (JCEP) Project, led by Prof Eric YH Chen, will be jointly organized with the Hospital Authority, Caritas Social Work Services and the Mental Health Association of Hong Kong.

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The objectives of JCEP are threefold. (1) Research – the effectiveness and health economic implications of early intervention services for psychosis will be evaluated through a randomized controlled trial involving 450 patients with first-episode psychosis. Research participants will be randomized to receive case management intervention for 2 or 4 years, with a comprehensive range of outcome measurements (eg, symptoms, functioning, quality of life) over 4 years, in order to address the optimal critical period intervention duration as well as their health economic implications. (2) Education – JCEP aims to enhance public awareness of psychosis, and to develop a trained network of professional gatekeepers skilled in the early detection of psychosis. Educational events will include public exhibitions, talks, media activities, website development, attitude surveys and professional trainings. (3) Service – within the capacity of JCEP a total of 1000 early psychosis patients aged between 25 and 64 years will receive intervention service and community-based group programmes provided by a specialized multidisciplinary team. The Project was officially launched on 31st August 2009 at the LKS Faculty of Medicine Building. The ceremony was officiated by Prof Lap-Chee Tsui, HKU Vice-Chancellor, together with Dr Donald Li, Steward of The Hong Kong Jockey Club; Dr York Chow, Secretary for Food and Health; Mr Shane Solomon, Chief Executive of the Hospital Authority; Ms Maggie Chan, Director of Caritas Social Work Services; and Prof Char-Nie Chen, President of the Mental Health Association of Hong Kong.

At the ceremony, the Project team has also invited a special guest, Prof Robert Miller, to speak from the perspective of both a patient and a scientist. Now retired and continuing to contribute as Honorary Research Fellow at the Department of Anatomy & Structural Biology, Otago University in New Zealand, Prof Miller is one of the earliest scholars to propose and publish on the role of dopamine in reward learning and its linkage with psychotic symptoms back in the 1970s. He spoke at the ceremony about the importance of early intervention programme with a public education component, which he thinks is essential for helping patients to overcoming the challenges brought about by the illness itself and the stigma around it.

An educational website has been set up at www.jcep.hk, providing in-depth information about psychosis for the public, as well as news and developments of the project.