Prevention and early intervention — structured clinical viva

Slide 1 map. Place each row: school programme = universal (small average effects if psychological curriculum-based); perinatal high-risk = selective; UHR clinic = indicated; EIS team = early intervention after onset, not pure primary prevention.^[1] Name Rose if examiner asks why universal still matters alongside clinics.^[2]

Slide 2 DUP. 12 months is long. Define DUP as frank psychosis onset to adequate treatment. Longer DUP associates with worse early outcomes — improve detection, GP pathways, soft-entry youth access, reduce stigma delays. Still deliver full multi-element care when presentation is late.^[7][8]

Slide 3 antipsychotics for all UHR. Answer no as default. Conversion is a minority outcome; network meta-analysis does not crown a single superior preventive package; metabolic harm and false positives matter. Offer structured assessment, comorbidity treatment, CBT-informed care, monitoring; reserve AP for specialist rationale or conversion/near-threshold severe cases.^[5][6]

Staging follow-up. Earlier stages → safer, lower-intensity care; escalate with progression (McGorry heuristic).^[3]

Depression prevention follow-up. Psychological indicated prevention reduces incidence (classic IRR ~0.78 framing).^[4]

EIS follow-up. Correll meta-analysis: EIS > TAU; RAISE comprehensive care superior to usual community care on key outcomes — name multi-element components.^[8][9]

Implementation follow-up. Evidence catalogues fail without workforce, fidelity, equity, and funding continuity (Campion public mental health implementation frame).^[10]