Street slang and schizophreniaBMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39419.647118.25 (Published 20 December 2007) Cite this as: BMJ 2007;335:1294
All rapid responses
Holmes et al  raise a very important point. Whereas there is at
present an impetus to develop ‘Early Detection Teams’ in order to identify
‘prodromal psychosis’ or ‘Ultra High Risk Mental States’, as a part of
Early Intervention Services for Psychosis, little thought has been given
to the subtleties of identifying such states and to the competencies that
doctors will need to identify them.
Holmes demonstrates one such competency, which is understanding the
nuances of the language which young people presently use, and other such
competencies could well include applying the psychological tests to which
Holmes et al refer, understanding the views on mental illness held by
persons from a variety of cultures, being able to elicit subtle symptoms
by probing questions, ability to use special tools, such as the
Comprehensive Assessment of At Risk Mental States [CAARMS] to map out
These skills are very great, and may very well be beyond the skills of
averagely trained Psychiatrists, Psychologists, and Nurses, however the
new Early Detection Teams are being recruited without the proper
delineation of such skills/competencies, and without proper planning for
training in them.
Without such competencies, Early Detection Teams are likely to fail.
Given the current need for such skills, could the Royal College of
Psychiatrists consider their definition and plan appropriate training for
doctors employed in such teams as a matter of urgency.
 Holmes O, Weinstein S, Tabraham P, Valmaggia L, Broome M, McGuire P ;
BMJ 2007 , Slang and Schizophrenia 335;1294
Competing interests: No competing interests