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Outreach and support in south London (OASIS): implementation of a clinical service for prodromal psychosis and the at risk mental state

Published online by Cambridge University Press:  16 April 2020

Matthew R. Broome*
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
James B. Woolley
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
Louise C. Johns
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
Lucia R. Valmaggia
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
Paul Tabraham
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
Rafael Gafoor
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
Elvira Bramon
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
Philip K. McGuire
Affiliation:
OASIS, PO 67, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
*
*
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Abstract

Background

While recent research points to the potential benefits of clinical intervention before the first episode of psychosis, the logistical feasibility of this is unclear.

Aims

To assess the feasibility of providing a clinical service for people with prodromal symptoms in an inner city area where engagement with mental health services is generally poor.

Methods

Following a period of liaison with local agencies to promote the service, referrals were assessed and managed in a primary care setting. Activity of the service was audited over 30 months.

Results

People with prodromal symptoms were referred by a range of community agencies and seen at their local primary care physician practice. Over 30 months, 180 clients were referred; 58 (32.2%) met criteria for an at risk mental state, most of whom (67.2%) had attenuated psychotic symptoms. Almost 30% were excluded due to current or previous psychotic illness, of which two-thirds were in the first episode of psychosis. The socio-demographic composition of the 'at risk' group reflected that of the local population, with an over-representation of clients from an ethnic minority. Over 90% of suitable clients remained engaged with the service after 1 year.

Conclusion

It is feasible to provide a clinical service for people with prodromal symptoms in a deprived inner city area with a large ethnic minority population.

Type
Original article
Copyright
Copyright ©Elsevier SAS 2005

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