Outreach and Support in South London (OASIS). Outcomes of non-attenders to a service for people at high risk of psychosis: the case for a more assertive approach to assessment
Outreach and Support in South London (OASIS). Outcomes of non-attenders to a service for people at high risk of psychosis: the case for a more assertive approach to assessment
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DOI：
10.1017/s0033291710000723
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发表时间：
2011-02-01
影响因子：
6.9
通讯作者：
Valmaggia, L. R.
中科院分区：
文献类型：
--
作者：
Green, C. E. L.;McGuire, P. K.;Valmaggia, L. R.
背景。国际协议规定，在“风险服务”实施任何评估或干预之前，客户必须寻求帮助。人们对那些拒绝投入的人知之甚少。本研究旨在确定“风险服务”中未参与人群的规模，将这一群体与参与社会人口统计学和临床特征的人群进行比较，并评估未参与服务的人群的临床结果。作为该服务临床协议的一部分，使用常规收集的数据对各组进行比较。自转介到南伦敦外展和支持（OASIS）以来，服务使用和精神病理数据间接从客户的全科医生（gp）和通过筛选当地精神卫生信托基金持有的电子病历收集。超过五分之一（n= 91,21.2%）的转介者没有参加或参与服务。大约一半的人随后被诊断出患有精神疾病。22.6%的人被诊断为精神病。近70%的人到其他精神卫生服务机构就诊。除了那些参与服务的人更有可能被雇用之外，没有人口统计学上的差异。超过五分之一被转介到精神病高危人群服务机构的人没有参加或参与。然而，这一群体中的许多人需要心理保健，而且相当大比例的人已经或将在以后发展为精神病。可能需要一种更自信的方法来评估那些处于精神病高风险但未能参与的个体。
Background. International agreement dictates that clients must be help-seeking before any assessment or intervention can be implemented by an 'at-risk service'. Little is known about individuals who decline input. This study aimed to define the size of the unengaged population of an 'at-risk service', to compare this group to those who did engage in terms of sociodemographic and clinical features and to assess the clinical outcomes of those who did not engage with the service.Method. Groups were compared using data collected routinely as part of the service's clinical protocol. Data on service use and psychopathology since referral to Outreach and Support in South London (OASIS) were collected indirectly from clients' general practitioners (GPs) and by screening electronic patient notes held by the local Mental Health Trust.Results. Over one-fifth (n=91, 21.2%) of those referred did not attend or engage with the service. Approximately half of this group subsequently received a diagnosis of mental illness. A diagnosis of psychosis was given to 22.6%. Nearly 70% presented to other mental health services. There were no demographic differences, except that those who engaged with the service were more likely to be employed.Conclusions. Over one-fifth of those referred to services for people at high risk of psychosis do not attend or engage. However, many of this group require mental health care, and a substantial proportion has, or will later develop, psychosis. A more assertive approach to assessing individuals who are at high risk of psychosis but fail to engage may be indicated.