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doi:10.1016/j.eurpsy.2005.03.001 
Copyright © 2005 Elsevier SAS All rights reserved.
Original article
Outreach and support in south London (OASIS): implementation of a clinical service for prodromal psychosis and the at risk mental state
Matthew R. Broomea, 
, 
, James B. Woolleya, Louise C. Johnsa, Lucia R. Valmaggiaa, b, Paul Tabrahama, Rafael Gafoora, Elvira Bramona and Philip K. McGuirea
Received 15 June 2004;
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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.
Method. – 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.
Keywords: Prodromal; Psychosis; Clinical; Service; Risk; OASIS
Article Outline
- 1. Introduction
- 2. Aims
- 3. Methods
- 3.1. Catchment area
- 3.2. Referrals
- 3.3. Assessment measures
- 4. Results
- 4.1. Socio-demographic characteristics of ARMS clients
- 4.2. Referral sources and pathways to care
- 4.3. Diagnoses and symptoms
- 4.4. Treatment
- 4.5. Transition to psychosis
- 4.6. Engagement and user satisfaction
- 5. Discussion
- 5.1. Recruitment of clients with an ARMS
- 5.2. Ethnicity
- 5.3. Presenting symptoms and clinical characteristics
- 5.4. Transition to psychosis
- 5.5. Logistical demands
- 5.6. The future of OASIS
- Acknowledgements
- References
