Setting up a new prodromal service in South London: feasibility study

摘要

Background: Providing intervention for individuals at clinical high risk (HR) of developing psychosis is helpful. However, the feasibility of setting up new prodromal services with limited resources requires evaluation.Aims: To assess the feasibility of providing such a service in a deprived urban area with high incidence of psychosis.Method: Two full-time members of staff (a clinical psychologist and a care co-ordinator) were employed to establish a clinical service for HR individuals in the London Borough of Lewisham. Service promotion and liaison with local agencies was undertaken with support from honorary staff. Activity was monitored over the first six months.Results: Each clinician spent an average of 10 hours per week on service promotion activities. All 44 general practitioner (GP) practices and 23 other agencies in Lewisham were contacted. 38 Early Detection training sessions were provided. In total, 32 referrals were received (~5 referrals/month). Referral rates tended to increase over time. Most referrals were from adult mental health services (59%). GPs referred 9 (28%) individuals and child and adolescent mental health services 4 (13%). 4 (12.5%) referrals were accepted, 6 (18.8%) are ongoing. 1 (3.1%) was not help seeking, 6 (18.8%) met threshold for fi rst-episode psychosis, and 15 (46.9%) had other mental health difficulties and were referred on. 1 (3.1%) accepted referral transitioned to psychosis.Conclusion: Setting up a HR Service is feasible with limited resources. Results of the current study were comparable to other well-established prodromal clinics. Service sustainability needs to be evaluated; increasing referral rates are likely to require more staff to manage effectively.