Perhaps I'm wrong about psychological therapies for the treatment of pscyhosis and psychotic disorders as a priority

At the moment provision of therapies for people with severe mental
illnesses is poor as it was for people with common mental disorder
before the IAPT programme. The evidence base for psychololgical
treatment of psychosis is poor in positivistic science reviews of high
quality trials but that doesn't mean psychological therapies don't work.

More importantly though is the journey through psychiatric care. It
starts from the moment of recognition of disorder or distress. It is the
entire journey that affects the outcomes. Psychological therapies are
rarely given early enough. What I'm talking about are interventions that
help at the beginning, for example in first-episode whatever (suicide,
mania, depression) that result in hsopitalisation.

I laughed at the idea of therapists in psychiatric wards because dealing
with an extremely unwell person can be difficult. However I was wrong
about that too. Good people can always get through to a person no matter
what state of mind they're in. My experience of wards was seeing
patients as nurses and therapists because that's the job they were doing
while the professional nursing staff stood as observers reporting back
to the psychiatrists and doing paper work. Where I was "Protected
Engagement Time" (where staff and patients interacted) for three hours a
day every week day was a significant improvement. That's how dire the
state of psychiatric hospital care is. I'd expect people need that sort
of care 24hrs a day and if it were available people could get better
sooner. Instead they're often left to rot on high levels of medication.

A better journey makes for better outcomes. The trauma of first time
hospitalisation can be ameliorated. The interventions used immediately
after hospitalisation can be scaled up to provide accessed to trained
professionals with lived experience of the condition to mentor an
individual at a vitally important stage. Like the Soteria paradigm,
first time hospitalisation can be seen as an opportunity to prepare the
individual to manage their condition long-term rather than just drugging
them and waiting for the drugs to kick in before discharging them.

There have already been small advances in the treatment of suicidal
crisis, for example the Maytree hospital. These are tiny and poorly
funded. These alternative paradigms of hospitalisation are desperately
needed for the best outcomes for the individual and society. People may
still need access to psychological therapies in the future to help them
through difficult times however it's the start of the journey where the
funds and the science, and compassion, are needed for the best outcomes.