Introduction

Bucks Early Engagement and Prevention (BEEP) is a clinical team working with individuals who have noticed a change in their mental health, mood, or behaviour and may be at risk of experiencing symptoms of psychosis.

Our aim is to support people before these changes become worse or develop into symptoms that are more difficult to cope with.

Our service specialises in supporting those who are at risk of developing a first episode of psychosis.

We aim to identify, assess, and treat people aged from 14 – 35 with an At-Risk Mental State (ARMS).

What is an At-Risk Mental State?

An ARMS can be described as a set of signs that indicate that someone is at high risk of developing psychosis.

If people receive support at an early point, before becoming unwell, it is hoped they are less likely to develop psychosis.

What are early signs of psychosis?

• Becoming more suspicious or worried of people in certain situations
• Feeling unsafe, or that people are working against you
• Believing you have special powers or abilities
• Noticing patterns or feeling that things have a special significance to you
• Finding it hard to follow conversations, getting muddled in your thoughts whilst speaking
• Feeling that your thoughts have been removed or tampered with, or that someone else is in control of your body
• Experiencing difficulties with relationships, daily activities, or struggling to cope at school, college or work
• Becoming more withdrawn and experiencing a loss of motivation
• Other changes may occur in your senses
• Sound: hearing noises others do not
• Sight: seeing things (objects/people/shadows) others cannot
• Touch: feeling something that is not there
• Taste: food tasting unusual
• Smell: smelling things others cannot

In addition, you may notice more general changes in your life such as:

• Being unable to sleep or sleeping too much
• Loss of concentration
• Increase or decrease in appetite
• Becoming more emotional or tearful
• Experiencing more intense emotions
• Becoming more irritable or argumentative
• Reduced pleasure in things you usually enjoy
• Reduced libido

What do we do

We offer evidence-based interventions for individuals and their families for up to two years, and monitoring for a further one year.

We work closely with neighbouring services and other support systems within the community to enable people to remain engaged with their day-to-day activities.

Who does BEEP support?

We work with people who may be experiencing mental health difficulties for the first time and are recognising one of the following:

• Those who have experienced psychotic symptoms, where these went away within one week, and without medication
• Those who have confusing, distressing, or unusual experiences which are infrequent or unclear
• Those who have a family history of psychosis and have difficulty living their life in the way they would want to

Our specialist services are for individuals who are registered with a Buckinghamshire GP.

What is the referral pathway?

1 Referral

This can be made by your GP or other health professional who will send it to the appropriate single point of access who will get in touch with us.

2 Assessment

Within 14 days of referral a comprehensive assessment will take place by BEEP clinicians.

3 Outcome

If you have an ARMS, treatment options will be discussed. If not, other alternative support options will be suggested with onward referral if appropriate.

4 Intervention

Evidence-based psychological interventions for you and your family will be offered. Support for additional needs can be discussed.

5 Monitoring

Once treatment is completed, BEEP will remain in contact for an agreed period of time to check your symptoms have not become worse.

Assessment

The initial assessment will be completed by one or two experienced professionals in our team. The assessment can take place at an NHS building across Buckinghamshire, in a community setting or at your home.

If you would like a friend or family member to support you in the assessment, you are welcome to bring them along with you. Sometimes it can be helpful having others with you as they might offer a different perspective, and help you remember some information.

The assessment will consist of questions aimed at helping us understand what is happening for you and how we may be able to support you. The duration of the assessment is usually 90 minutes long. We will happily answer any questions that you may have.

Treatment options

• Psychological Assessment
• Psychoeducation
• Coping strategies
• Support with work/school
• Help engaging in social activities
• Cognitive Behavioural Therapy (CBT)
• Behavioural Family Therapy (BFT)
• Family/Carer Interventions