[The romande fidelity scale for early intervention in psychosis]

The Early Intervention in Psychosis (EIP) model has become the "gold standard" for the treatment of young patients with emerging psychotic disorders. In Switzerland, however, the model remains insufficiently developed, and access to care varies substantially across regions. To establish a common language and a shared definition of EIP, a working group from the French-speaking Swiss cantons (Romand) developed the Romand Fidelity Scale for Early Intervention in Psychosis (EFRIPP) between 2023 and 2024. The EFRIPP was designed to: (i) define the essential criteria for establishing an EIP service adapted to the Romand context for centers wishing to implement this practice; (ii) prevent divergence from elements with proven scientific effectiveness; and (iii) create a harmonized tool for training new mental health professionals and supporting a concrete understanding of the EIP model.

A multidisciplinary group from the public psychiatric services of the Swiss cantons of Vaud, Neuchâtel, Geneva, Valais, Fribourg, and Jura met four times a year between 2023 and 2024 to develop the EFRIPP. The authors of this article are members of this group. The EFRIPP draws on several existing fidelity scales (UK, Denmark, Australia, Quebec) but are primarily based on the Quebec scale, given the cultural and linguistic proximity between Switzerland and Quebec.

The EFRIPP is organized around a set of core EIP criteria, divided into three sections assessing: (i) the structure and organization of the EIP center; (ii) clinical modalities and processes; and (iii) support for practitioners. Overall, the EFRIPP includes 44 criteria: 30 rated continuously (1-5) and 14 rated dichotomously (0=absent; 1=present). À weighted scoring system yields a total score, categorized as "insufficient adherence" (0-100), "minimal adherence" (101-120), "acceptable adherence" (121-140), "good adherence" (141-160), or "excellent adherence" (161-176).

We hope that this tool will help harmonize of EIP practices in French-speaking Switzerland and support their implementation across the cantons, so that young patients developing a psychotic disorder have access to the best possible care, regardless of where they live.