Preventing psychosis in young people

Psychotic disorders (including schizophrenia) affect more than 20 million people globally. They commonly emerge in late adolescence and early adulthood and are among the most costly and burdensome disorders worldwide. It is imperative to prevent their onset.

Extensive research conducted at Institute of Psychiatry, Psychology & Neuroscience and National Institute for Health Research (NIHR)-Maudsley Biomedical Research Centre indicated that young people (12-35 years-old) who are struggling with experiences like hearing voices or feeling paranoid are at high risk of developing psychosis over 2-3 years.

Our research indicated that by identifying these individuals and intervening early using talking therapy, it is possible to reduce the onset of psychotic disorders by 60 per cent, improve outcomes even if psychosis develops, and achieve economic savings.

Our research has informed national/international clinical guidelines (e.g., NICE, Royal Australian/New Zealand College of Psychiatrists), been adopted by NHS England and South London and Maudsley NHS Foundation Trust, which is now funding the service and its expansion into Lewisham, Croydon, and Southwark, and contributed to the discovery of new diagnoses (DSM-5 Attenuated Psychosis Syndrome).

Outreach and Support in South-London (OASIS) community

These findings provided justification and initial funding to establish the Outreach and Support in South-London (OASIS) community mental health team in Lambeth. OASIS provides detection, assessment and primary (“targeted”) prevention to young people at high-risk for psychosis. OASIS offers multidisciplinary care, including talking therapies, personalised medical consultation, practical assistance with housing/finances, and support for families/carers.

OASIS aims to help young people deal with any issues they are facing and prevent transition to psychosis. OASIS provides non-stigmatising, psychologically-oriented, transitional, community-based care, preventing young people from falling through the cracks of paediatric/adult mental healthcare, and delivering public mental health promotion in the local community.

Harnessing OASIS infrastructure to address other conditions

The OASIS clinical research model benefited from strong clinical-academic collaboration, innovative research infrastructures (the largest NHS preventive mental health service for psychosis in UK/Europe, having supported more than 800 young people) and provides training nationally for early detection/intervention.

Over the next five years, we aim to leverage OASIS’s clinical research infrastructure to test whether we can additionally support young people at high-risk of developing depression/bipolar disorders.

We will test new methods to identify which treatments will most benefit which individuals, to provide personalised care. Our longer-term ambition is to research the best model of care that works across diagnoses to prevent severe mental disorders in young people to be rolled out in the NHS and globally.

 

IMPACT AREAS:

Developing Resources for Research | National and International Collaboration | Improving Access and Uptake | Personalising Treatment to Patients