Understanding the Current State of Play of Early Intervention for Bipolar Disorder: Qualitative Analysis of Consultations With International Stakeholders

BACKGROUND: Despite the burden associated with bipolar disorder (BD), research into early diagnosis and treatment of BD lags approximately 20 years behind the field of early intervention for psychosis. This study evolved through a partnership between Orygen (Melbourne, Australia) and the Daymark Foundation (Toronto, Canada). The primary focus was to answer the question: "How might we advance an early intervention approach for people at-risk of or with BD?". METHODS: Semi-structured interviews were conducted with international experts and other stakeholders in early intervention and BD to identify challenges and barriers in early intervention approaches to BD. RESULTS: Twenty-eight experts participated. Nine themes emerged as challenges: (i) limited recognition and understanding of BD across stakeholders; (ii) lack of definitions; (iii) poor resourcing and lack of prioritisation in funding models; (iv) absence of validated tools for diagnosis, monitoring treatment response and/or disorder progression; (v) absence of "big data"; (vi) scarcity of evidence-based treatments and clinical guidelines for the early stages of the disorder; (vii) obscurity around optimal service models; (viii) the need for better support and involvement of families and significant others; and (ix) the need for collaboration (across disciplines, stakeholders, and settings) to progress the field. LIMITATIONS: Of those approached, 54.9% participated in the study. Given the qualitative nature of the study, recruiting more experts to the study would not necessarily change the outcomes as data saturation was achieved. CONCLUSIONS: This work lays the foundations for developing a collaborative research framework to progress early intervention for young people with BD.