How our service can help you
The Affective Disorders Outpatient Service is a national, specialist outpatient service at Maudsley Hospital. We provide assessment, treatment and care for people aged over 18 who have complex or treatment-resistant mood disorders, including depression and bipolar disorder. Our experts are internationally recognised senior clinicians and researchers in this speciality with many years of experience.
The service welcomes referrals from general practitioners and secondary care services supported by evidence of on-going Community Mental Health Team (CMHT) involvement and agreement for this to continue were the patient to be seen in the National Affective Disorders Outpatient Department. The Service provides advice about diagnosis and treatment and may suggest treatment strategies to be implemented by the local secondary team.
Referrals must be approved by the local integrated care board.
- Service Borough Covers: National (Adult services) Treatment type: Treatment Resistant Mood Disorders
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Contact the service
Site Location: Maudsley Hospital Email: NADS@slam.nhs.uk Phone Number: 020 3228 4678 - Disabled Access: Stepless access available via ramp and lift
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Address:
c/o Carol Bell
Lambeth Hospital
1st Floor McKenzie Annexe
Landor Road,London, SW9 9NU - Conditions: Anxiety, Bipolar disorder, Depression, Psychosis
Other essential information
Interventions
- Clinical assessment including structured clinical interview
- Blood tests, ECG, MRI scan - recommendations only
- Expert pharmacotherapy, including complex combinations and high dose regimens if indicated
- Electroconvulsive therapy
- Plasma level monitoring for antidepressants, anti-psychotics and anticonvulsants
- Assessment for suitability for neurosurgical intervention, including deep brain stimulation, vagal nerve stimulation and ablative procedures
- Joint working, where appropriate, with the National Psychosis Unit
- Joint working with the individual’s mental health team to facilitate smooth transition back to local care
- Post treatment follow-up appointments, if indicated
Eligibility criteria
- 18 years and older
- Male or female
- Treatment resistant affective disorders: unipolar or bipolar disorders, including mixed mania and rapid-cycling disorder
- Affective disorders requiring specialist psychological interventions
- Healthcare professionals with affective disorders
- Depression with a seasonal pattern (seasonal affective disorder)
- Ongoing engagement and support of a local consultant and community mental health team. This criterion is of key importance to permit joint working and crisis management, the local consultant and Community Mental Health Team(CMHT) must confirm responsibility for their patient during treatment and at least up to one year following discharge from our service
Exclusion
- Patients who are currently suicidal or there are other current ongoing self harm issues must not be referred to NADS and should be managed by their CMHT until stable
- High risk of self-harm or other vulnerabilities that render outpatient attendance inadvisable.
- Lack of engagement with local consultant and community mental health team to co-ordinate ongoing care
- Emergency or urgent patients
Outcomes
- Detailed treatment plan with recommendations for interventions to be provided locally
- Outpatient pharmacological and/or psychological intervention, if indicated
- Episode intervention and recurrence prevention
- Discharge back to secondary care team at the earliest appropriate juncture
- Less frequent need to access local mental healthcare services and reduced care costs
- Improved well-being and functional capacity
- Education for patient and carer about the nature of the illness and strategies to promote health, prevent recurrence and encourage a personally meaningful recovery
Care Options
Medical costs
It is important the patient referred to the Service remains engaged with their CMHT for implementation of the Treatment Recommendations and to provide ongoing prescriptions for the patient. NADS is not funded for prescribing medications, all medication costs remain with the patient’s community team, whether CMHT, private psychiatrist and or Gp. In cases where a Gp cannot prescribe or does not prescribe a particular medication, the CMHT should then prescribe.
The National Affective Disorders Service will always work with each patient’s local CMHT; we provide advice about diagnosis and treatment and often suggest treatment strategies to be implemented by the local secondary team. In cases where a Gp cannot prescribe or does not prescribe a particular medication, the CMHT should then prescribe, the referral must confirm agreement to prescribe the patient’s medications and also be responsible for the costs of any specialist treatments should the patient need this.
