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Neuropsychiatry Services

How our service can help you

Overview Our Neuropsychiatry Service manages the psychiatric complications of neurological and neurosurgical disorders, including epilepsy, Parkinson’s, memory disorders, brain tumours and functional neurological disorders (FND) among others.

Maintaining close links with the Institute of Psychiatry, Psychology and Neuroscience, our experts offer specialist assessments and evidence-based, patient-centred treatment options in a wide array of settings: outpatient, day hospital, inpatient, general hospital (liaison).

 

  • Service Borough Covers: National (Adult services) Treatment type: Inpatient, outpatient, outreach

  • Contact the service

    Site Location: Multiple sites Email: slm-tr.neuropsychiatryreferralhub@nhs.net Phone Number: 020 3228 2330
  • Business Hours/Visiting Hours: Please check with individual sites

    • Other essential information

  • Conditions: Neuropsychiatry

Eligibility criteria

  • Age: Over 18 - although primarily an adult service (18 to 65), referrals are considered on an individual basis for those over the age of 65
  • Complexity: Tertiary level service; therefore patients should have identified interfacing neurological and mental health needs and have received local input prior to referral to our service. We are unable to provide crisis input, urgent or community care, and if this is required patients will need to remain open to local services alongside our service.
  • Symptoms and disorders: any identified or suspected psychiatric symptom (affective, psychotic, cognitive and others) resulting from a neurological and/or neurosurgical disorder, including nervous system complications of systemic disorders (HIV, systemic lupus erythematosus (SLE), Sarcoidosis, metabolic disorders and others). Functional neurological disorders that require input above what can be offered locally.
  • Pre-operative assessments: we offer comprehensive psychiatric assessments for patients wishing to undergo deep brain stimulation and epilepsy surgery 

If uncertain, please email us on slm-tr.neuropsychiatryreferralhub@nhs.net.

Referrals

To refer to the service please email the following referral form to slm-tr.neuropsychiatryreferralhub@nhs.net

Please also include any other relevant clinical details including recent clinic letters and investigation results, as insufficient information may lead to your referral being declined.

Neuropsychiatry Referral Form.docx [docx]

Care Options

The information on this page describes the Neuropsychiatry Services care options and associated treatments.

Outpatient Services

Locations and consultants

  • King’s College Hospital
    • Dr Sotiris Posporelis
    • Dr Paul Shotbolt
  • Maudsley Hospital
    • Dr Simon Harrison
    • Dr Al Santhouse
    • Dr Biba Stanton*
    • Professor Mark Edwards*
  • St Thomas’ Hospital
    • Dr Mervi Pitkanen
    • Dr Tim Segal

* Dr Biba Stanton and Professor Mark Edwards are consultant neurologists 

Outpatient treatments

Specialist cognitive behavioural therapy (CBT)

The Trust has been at the forefront internationally in developing specialist CBT for functional neurological disorders (FND) and building an evidence base for its use with large multicentre clinical trials. We have four full time CBT therapists providing outpatient CBT at the Maudsley Hospital – Ken McKeown, Lorenza Tedesco, Nishat Ahmed, Attiya Ahmed and Fabio Simiao. If deemed suitable, courses of treatment are usually one hour long session per week for 12 to 14 weeks. 

Neurophysiotherapy for ‘motor’ FNDs (for example, limb weakness and movement disorders such as tremor or dystonia)

Outpatient specialist physiotherapy for functional neurological disorders (FND) is available with the appointment of Emily Jay, highly specialised neurophysiotherapist. 

Transcranial magnetic stimulation for ‘motor’ FND (for example, limb weakness and movement disorders such as tremor or dystonia)

Transcranial magnetic stimulation (TMS) is available for selected patients with motor functional neurological disorders (FND) (especially severe weakness) at King’s College Hospital with Dr Tim Nicholson, including as part of the TONICS randomised controlled trials. The development of a routine clinical service is planned.

Liaison Neuropsychiatry Services

This service is available only to inpatients at King’s College Hospital and St Thomas’.

Locations and consultants

  • King’s College Hospital - Dr Sotiris Posporelis
  • St Thomas’ Hospital - Dr Mervi Pitkanen

Day hospital service (FiND programme)

The FiND Programme (functional integrated neurological disorders) is an outpatient rehabilitative group therapy programme specialising in the treatment of functional neurological disorders (FND). It provides a holistic and integrated approach using aspects from psychiatry, psychology and physiotherapy. 

We are currently adjusting this service but the programme typically runs for either three or eight weeks and patients attend our unit at the Bethlem Royal Hospital for two full days (9.30am to 4pm) each week. 

Potential attendees must have suitable rehabilitation goals, have achieved a level of self-management so that they are independent with personal-care and additionally are able to transfer in and out of a taxi independently. 

Attendance and travel arrangements are typically limited to people who live within 40 miles of the Bethlem Royal Hospital.

Other specialist services

Encephalitis Clinic

The autoimmune encephalitis clinic is a joint multidisciplinary neuropsychiatric clinic dedicated to the assessment and management of patients with confirmed or suspected autoimmune encephalitis and other central nervous system autoimmune disorders, at King’s College Hospital, London. 

All patients at this clinic are seen jointly by a neurologist and a psychiatrist (Dr Tom Pollak), an approach we believe is essential to ensuring the best possible patient care. We also provide 'in-reach' advice, assessments and opinions for mental health teams within the Trust. 

FND Psychoeducation Group

This is a pilot initiative for individuals diagnosed with a functional neurological disorder and their carers. Organised by Dr Tim Segal and Dr Biba Stanton, it aspires to enhance people’s understanding of their condition and introduce to self-management techniques through presentations from members of the multidisciplinary team.

Care Options - Inpatient Services

Inpatient Service (Lishman Unit, Bethlem Royal Hospital)

The Lishman Unit is a 15-bedded inpatient ward located at the Bethlem Royal Hospital. This is a specialist neuropsychiatry inpatient unit offering multimodal assessment and treatment by a multidisciplinary team of experts. 

We also have significant experience in complex discharge planning for patients who require ongoing care and support after leaving hospital. 

This is a national service which accepts referrals from the whole of England. Once referrals have been accepted, the team carries out a pre-admission assessment to determine suitability for admission. 

We generally admit two types of patient: 

  • Patients with severe functional neurological disorder (FND): We are one of very few specialist inpatient units in the UK who admit patients with severe disabling FND. Please be aware that because there are only a small number of such units nationwide, this service receives a very high number of referrals and the waiting time for admission is lengthy. The inpatient treatment programme involves multidisciplinary therapy input from a team comprising physiotherapy, occupational therapy, clinical psychology, and speech and language therapy, in addition to medical and nursing input. Admissions typically last 12 weeks, though this can vary.
  • Patients with neurological disease or damage who require complex neuropsychiatric treatment and/or neurorehabilitation: Mostly these are patients who have sustained an acquired brain injury (ABI) but we also take patients with neurological conditions (for example, Parkinson’s disease, multiple sclerosis, post-encephalitis) when these conditions are associated with cognitive problems or other psychological issues. Many of these referrals come from other hospitals and we are usually able to admit these patients within two to three weeks. The unit does not usually admit patients with severe alcohol-related brain damage (ARBD) as these patients generally require slower-stream rehabilitation. 

We also occasionally admit unusual cases where diagnosis may be unclear. If you are unsure whether a particular patient is suitable for this unit, we are always happy to discuss cases. 

Locations and consultants

  • Bethlem Royal Hospital – Dr Nick Medford

Our experts

Dr Alastair Santhouse:- Read more

Dr Biba Stanton:- Read more

Clare Grey: - Read more

Dr David Okai: - Read more

Dr Sotiris Posporelis: - Read more

Prof Laura Goldstein: - Read more

Dr Mary Summers:- Read more

Dr Nick Medford: - Read more

Paul Shotbolt: - Read more

Simon Harrison: - Read more

Dr Tim Nicholson: - Read more