General practitioners and early intervention in psychosis: reply

We wish to express our thanks to Dr Bowers for the interest in our article. ¹ Dr Bowers feels that the majority of GPs reporting seeing only one or two patients with first-episode psychosis a year is a low figure. However, this agreed with Shiers & Lister's findings. ²

Dr Bowers expressed reservations about the GPs’ ability to answer questions about their prescribing trends to patients with first-episode psychosis. I may disagree with this view as the low number of patients does not exclude or make it difficult for GPs to comment on engagement or otherwise. It is our view that clinicians, including GPs, may be more able to remember cases that are not very frequently seen than common ones.

Dr Bowers’ suggestion that getting the patients’ views on barriers to mental health services would certainly have helped to triangulate the data – this puts forward the idea for another study. The scope of this study was about GPs’ experience and not patients’ or carers’ experience.

Finally, Dr Bowers expressed his concern about the length of time elapsed between conducting our study and the results being published. We appreciate the importance of avoiding such delay but would point out the following: (1) clinicians with numerous clinical duties need to plan the study, make the time for data analysis, writing and submitting papers, responding to reviewers, and wait after putting the paper in the queue of the articles accepted for publication until it is published; (2) the real question should be whether or not this delay has any impact on applicability of the study results. We feel that where the early intervention service model has already been adopted it is not too late for it to be reviewed and further developed. If, on the other hand, some areas have not yet developed their early intervention model, it is not at all late.