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National services

Adult services

National services

Adult services

National services

Adult services

National services

Adult services

Psychosis Service


Location:
 

Contact information:
 

Mode:
 Inpatient and outpatient

Referrals are accepted from:
 We welcome referrals from across the United Kingdom, the Channel Islands and the Isle of Man. Referrals can also be accepted from the European Union. Access to this service is subject to clinical commissioning group (CCG) or commissioning support units (CSU) specialist mental health commissioning arrangements. We also accept self-funded referrals nationally and internationally 

Key mental health conditions:
 schizophrenia, schizoaffective disorder, psychotic depression, psychosis, drug-induced psychosis, delusional disorder, bipolar disorder, psychosis with co-morbid physical health condition, psychosis which has not responded to treatment

Overview

The National Psychosis Service (NPS) is a clinical-academic tertiary service offering innovative individualised evidence-based multidisciplinary strategies to help those people with complex psychosis where standard treatment guidelines have proven ineffective or have not been tolerated. The service aims to enhance quality of life through tailored treatments and promotion of recovery thus reducing the need for high intensity placements and the risk of readmission.

Internationally renowned expertise in resistant psychosis is provided by a team of dedicated clinicians offering comprehensive medical reviews alongside innovative, bespoke treatment approaches. Themes include complex co-morbid physical health conditions which directly affect psychiatric treatment options; clozapine re-challenge after a significant adverse reaction; clozapine non-response (ultra-treatment resistance).

Our specialist service is supported through established partnerships with the academic Departments of Psychosis Studies and Psychology based within the Institute of Psychiatry, Psychology and Neuroscience, King’s College London We also liaise with clinical experts within other specialties across King’s College London and King’s Health Partners. The National Psychosis team is closely linked to the Maudsley Pharmacy and the other national specialist mental health services.

The service aims to enhance quality of life through collaborative working towards recovery. Patients who benefit from our service enjoy excellent outcomes and we regularly audit and publish service outcomes. Benefits include reduction in psychosis, less frequent episodes of illness, improved social functioning, better understanding of the illness by the patient and carers and enhanced engagement with physical and mental health care plans. We have published evidence that admissions result in reduced morbidity, fewer acute and psychiatric intensive care unit (PICU) bed days, lower antipsychotic doses, substantial reduction to risk of readmission or high intensity placements and less expensive long-term costs.

Our experts include some of the most highly cited in our field worldwide. Our focus on treatment resistant psychosis over three decades has enabled us to become a world class centre of excellence in this field. For instance, our research group on the antipsychotic drug clozapine is the most highly cited worldwide.

As our patients may be a long way from home, we aim to make admissions as short as possible and communicate regularly with carers, the referring team and CCGs or CSUs to plan care and facilitate timely discharge.

Our clinicians offer education and training in the assessment and management of difficult to treat psychosis. This is available for individuals or small groups of professionals or may be extended as an outreach package for team-based training of larger groups. In addition, for those wishing to develop refractory psychosis services, consultations are provided to clinicians, managers and commissioners. The programme delivers the following outcomes:

  • Develops an understanding of the theoretical principles that underpin the effective assessment and management of resistant psychosis
  • Increases clinicians’ competence and confidence in the assessment and management of resistant psychosis
  • Explores ways in which psychopharmacological and psychotherapeutic skills can be combined with knowledge of emerging treatment strategies in resistant psychosis, including how to optimise clozapine treatment and reduce the medical risk associated with persistent psychosis