PsyMaptic was developed in response to a need to provide policymakers, commissioners and service providers with evidence-based information about the likely number of people requiring treatment for suspected psychosis in Early Intervention in Psychosis [EIP] services in England.
EIP services were mandated by the Department of Health to be established nationally in 2002, with recognition that psychosis need may vary in different populations. At the time, no tools were readily available to inform service commissioning and planning about possible variation in local need.
From around 2009, two of the lead investigators on the PsyMaptic project (James Kirkbride, Peter Jones – see Our Team) began exploring ways to translate empirical knowledge about how risk and incidence of psychotic disorders varied by person and place into a usable tool for EIP service planning.
Kirkbride and Jones drew on their previous experience and involvement in two of the largest epidemiological studies of first episode psychosis in England at the time, the Aetiology and Ethnicity in Schizophrenia and Other Psychoses [AESOP] study (on which Jones was a Co-PI) and East London First Episode Psychosis [ELFEP] study led by Prof Jeremy Coid. These two studies established strong evidence for variation in the incidence of psychotic disorders in England by age group, sex and ethnic group, as well as by place, with more urban, deprived and unequal neighbourhoods showing higher rates of disorder.
Using this empirical data, Kirkbride and Jones collaborated with a biostatistician at the MRC Biostatistics Unit at the University of Cambridge (Dr Dan Jackson) to develop Versions 0.5 and 1.x of the PsyMaptic prediction tool for psychosis in England. Predictions of psychosis incidence from the tool were validated against observed data from a third empirical study of the epidemiology of first episode psychosis, the Social Epidemiology of Psychoses in East Anglia [SEPEA] study (PI: Kirkbride, Co-I: Jones).
The final version of the tool predicted the expected incidence of ICD-10 psychotic disorders (F10-33) in England, at lower-tier Local Authority District [LAD] level, by major age group, sex and ethnic group, taking into account LAD variation in deprivation and population density. It predicted need according to the size and structure of the population of England from the 2011 Census of Great Britain.
We launched Version 1.1 of the tool and the prediction data as an open access resource in 2013, following peer-review of the methodology and publication in BMJ Open. The tool has since been used to inform EIP commissioning and planning in England in a variety of ways, including informing NICE guidelines and Health Education England resourcing for EIP services following the introduction of the 2016 national Access and Waiting Times Standard.
Over time, it has become necessary to update the methodology underpinning predictions from the PsyMaptic tool. In part this is due to use of the 2011 Census data which may no longer provide an accurate picture of the underlying population at-risk in England to inform EIP service planning. In 2017, we began developing Version 2.0 of the PsyMaptic tool to provide more granular, long-range forecasts of future need for psychosis in England, up to 2025, and potentially beyond. You can read more about our methodology behind Version 2.0 of the tool and how it enhances our previous prediction model.
Version 2.0 of the tool was developed thanks to a Wellcome Trust award (PI: Kirkbride based in the Division of Psychiatry, UCL), and with the continued support and collaboration of Prof. Peter Jones (University of Cambridge) and Prof. Jeremy Coid (Chengdu University). We also collaborated with Prof Gianluca Baio from the Department of Statistical Sciences, UCL, Prof Paul French (Manchester Metropolitan University), Prof David Osborn (UCL) and Dr Pia Wohland-Jacker (University of Queensland), who brought her demographic modelling skills and expertise to the project to provide projections of the likely future population structure in England up to 2025.
We have produced Version 2.0 of our new tool to inform EIP service planning over the next 5 years, consistent with the timeframe of the NHS Long Term Plan and the Mental Health Implementation Plan. The updated forecast data from the tool (available via either our visualisation dashboard or as downloadable data) are already being used by NHS England and NICE to inform future service planning.