Psychosis and schizophrenia in adults: prevention and management

Treatment for a first episode

If you have a first episode of psychosis, you should be offered both:

See antipsychotic medication and psychological therapy for more information.

Treatment for another episode

If you have another episode, you should be offered the same treatment (antipsychotic medication, CBT and family intervention) as for a first episode, or a review of your current treatment.

You may continue to receive treatment and care from the early intervention service, but you may also be offered treatment by a crisis resolution and home treatment team if you need more urgent care. The team will try to treat you at home or in a crisis house (an alternative to hospital that helps people keep their independence during a crisis) or day hospital, but some people with psychosis and schizophrenia may need to be admitted to hospital (see if you need to stay in hospital).

In addition to antipsychotic medication, CBT and family intervention you may also be offered an arts therapy, particularly if you are withdrawn and have lost interest in things that you used to enjoy.

See antipsychotic medication and psychological therapy for more information.

You should continue therapy after you have left hospital or another service until you have completed the course.

Treatments that have not been prescribed

If you wish to use treatments that have not been prescribed by your healthcare professional, including complementary therapies, you should discuss this with your healthcare professional. They should advise you whether such treatments are safe, helpful and whether they are likely to affect your prescribed medication and psychological therapy.

If you need to stay in hospital

If you need to stay in hospital for treatment, the hospital should be suitable for someone of your age and gender, and your family or carer should be supported, especially if the unit is a long way from where they live. The crisis resolution and home treatment team can help you go home earlier.

For more information on what should happen if you need to stay in hospital and what should happen if you are treated under the Mental Health Act, see NICE's guideline on service user experience in adult mental health.

If there is a risk to yourself or others

If you are very unwell and could be a risk to yourself or others you may be given medication to help calm or 'sedate' you.

As soon as possible afterwards, healthcare professionals should talk to you about what has happened and explain why you were sedated. They should make detailed notes and encourage you to write your own account to go in your medical notes.

If you have harmed yourself or your behaviour is threatening or violent, you should receive treatment and support. (See the section on other NICE guidance for details of our guidance on self-harm and managing disturbed or violent behaviour.)