For over a century, a corrosive blend of pessimism, stigma, and neglect have confined therapeutic efforts to delayed and to inconsistent palliative care in relation to psychotic disorders.’ (McGorry et al., 2008)

Critically discuss how therapeutic changes have evolved from what McGorry (2008) describes above to the way that psychosis is currently treated within an evidenced based early intervention psychosis programme.

Psychotic disorders and particularly schizophrenia are serious and sometimes fatal illnesses which typically emerge during the sensitive developmental period of adolescence and emerging adulthood 1. For over a century, a corrosive blend of pessimism, stigma and neglect have confined therapeutic efforts to delayed and inconsistent palliative care. Much of this can be attributed to the conceptual error underpinning the concept of schizophrenia, namely that a true disorder could be validly defined by its (poor) outcome. This error was, in turn, a legacy of the 19th century degeneration theory, which has been allowed to influence the field well beyond its use‐by date 2. Although Kraepelin himself and some of his contemporaries ultimately recognized the fallacy, his dichotomy (between dementia praecox and manic depressive insanity) has withstood several challenges and has been strongly reinforced with the advent of operational diagnostic systems. This has not only hampered neurobiological research, but has caused widespread iatrogenic harm and inhibited early diagnosis because of an exaggerated fear of the expected outcome.

Until recently, apart from transient and illusory optimism generated by the mental hygiene movement in the 1920s, early intervention for psychotic disorders has been the furthest thing from the minds of clinicians and researchers. Ironically, however, since the early 1990s, this hitherto barren landscape has seen the growth of an increasingly rich harvest of evidence, and widespread national and international efforts for reform in services and treatment approaches, setting the scene for more serious efforts in early intervention in other mental disorders