Patients with first episode psychosis benefit from immediate referral to high-risk services, says study

Patients with first episode psychosis (FEP) benefit significantly from immediate referral to high-risk mental health services, according to a new study.

It is widely acknowledged that treatments for psychotic disorders are more effective if they are given earlier in the course of illness. However, many affected individuals experience long delays before receiving appropriate healthcare.

Specialised high-risk clinical services have been developed to offer treatment to people at risk of psychotic disorders. High-risk services can also play an important role in detecting FEP before the onset of a severe psychotic disorder. 

Researchers from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London reviewed clinical records of nearly 3,000 patients from the South London and Maudsley NHS Foundation Trust (SLaM). They compared clinical outcomes in FEP patients who presented to OASIS, a high-risk clinical service in South London, with those who received conventional care.

The study, published in Acta Psychiatrica Scandinavica, found that FEP patients who presented to OASIS spent 17 fewer days in hospital, had a shorter referral to diagnosis time, a lower frequency of admission and a lower likelihood of compulsory admission under the Mental Health Act in the 24 months following referral, compared with FEP patients who were first diagnosed at conventional services.

Dr Paolo Fusar-Poli from the Department of Psychosis Studies said: “Our research indicates that high-risk services such as OASIS play an important role in identifying people with FEP and fast-tracking their treatment. These findings highlight the need for early intervention and preventative strategies in treating people with psychotic disorders.”

Dr Rashmi Patel, also from the Department of Psychosis Studies, added: “The main difference between OASIS and conventional care is ease of access. People can be referred to OASIS not only by their GP or other mental health services but we also promote referrals from psychologists, schools/colleges, family members and self-referral. People who are referred are generally assessed quickly and if they are found to already be psychotic, they are rapidly referred on to first episode early intervention services.”

This research was funded by the National Institute for Health Research Biomedical Research Centre at SLaM and King's College London.