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National Affective Disorders Service

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 18 and over, 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
  • Contact the service

    Site Location: Maudsley Hospital Email: Phone Number: 020 3228 4678
  • Disabled Access: Stepless access available via ramp and lift
  • Address: c/o Carol Bell
    Lambeth Hospital
    1st Floor McKenzie Annexe
    Landor Road,
    SW9 9NU
  • Other essential information

  • Conditions: Anxiety, Bipolar disorder, Depression, Psychosis


  • 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
  • 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.


  • Patients who are suicidal or 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


  • 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


Care option: Tertiary, One Off Second Opinion Assessment

Code: 92945

Unit: Per assessment

Description:An in-depth, one-off assessment of the person's affective disorder by our internationally recognised experts and their team. A detailed written report will be provided four to six weeks after assessment, which will include formulation and specific recommendations for further treatments, to be undertaken by the patient’s local consultant and community mental health team. 


Care option: Tertiary, second opinion follow up appointment treatment 

Code: 39402

Unit: Per session

Description: Following a one-off second opinion assessment, treatment sessions may be offered and are conducted by a consultant psychiatrist or with another member of the medical team. Up to 10 review appointments may be advised initially, subject to prior agreement and funding. Further appointments may be arranged if necessary, again, subject to agreement and funding. 

This package is intended to supplement, not to replace, local secondary care which is a pre-requisite to referral to the service. 


Care Option: Specialist Affective Disorders Treatment for Health Care Professionals

Care option code: 92945 - One Off 2nd Opinion Assessment

Description: New patients must first be seen for a One Off 2nd Opinion Assessment.  This Care Option is for healthcare professionals for whom local services are inappropriate for reasons of confidentiality. Our senior clinical academic psychiatrists have considerable experience in treating such individuals and expertise in the management of their complex needs. 

Care Option code: 39402 - Outpatient treatment sessions

The main focus of the outpatient treatment programme is the return of the individual to their professional work in the health service whenever possible, the prevention of recurrence and the avoidance of further health-related absence. 

Initiation and ongoing monitoring of novel drug treatment regimens consists of half an hour sessions with a consultant psychiatrist to discuss progress, review treatment, address side effects and undertake blood monitoring tests where indicated (drug blood levels, full blood count, urea and electrolytes, liver function tests and thyroid function tests). 

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).

The Maudsley Advanced Treatment Service

The Maudsley Advanced Treatment Service (MATS) offers specialist assessment and advanced treatment, for persons who are patients of Maudsley Hospital who live in the 4 Boroughs of Lambeth, Southwark, Lewisham and Croydon only.

MATS provides assessment, treatment recommendations and follow-up appointments for patients with treatment-resistant mood/affective disorders, including difficult to treat depression, treatment-resistant depression, and treatment-resistant bipolar disorder and includes evaluation, treatment recommendations for advanced treatments such as Electroconvulsive Therapy (ECT), Vagus Nerve Stimulation therapy (VNS), Ketamine, Esketamine complex and/or novel pharmacotherapy.

MATS operates under clinical governance from the National Affective Disorder Service (NADS) and South London and Maudsley NHS Foundation Trust.

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).

Our experts

Dr Roland Zahn: - Read more

Dr Mario F P Juruena: - Read more

Prof Allan Young: - Read more

Prof Anthony Cleare: - Read more

Dr James Rucker: - Read more

Dr Paul Stokes:- Read more

Dr Rina Dutta: - Read more

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