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National Psychosis Service - Outpatients

How our service can help you

We provide a national, specialist outpatient assessment, treatment and rehabilitation service for people, aged over 18, who have complex psychosis, including schizo-affective disorder. A psychotic illness involves distorted perceptions of reality thinking, feeling, hearing and seeing often with symptoms of hallucinations and delusions.
National services are for people who live throughout the United Kingdom.

We treat people's physical and mental health. Our aim is to help people maintain their health and to reduce the risk of hospital readmission.

We encourage people, and their carers, to be actively involved in all decisions made about their treatment and care.

Due to Covid the out-patient service is accepting referrals and undertaking virtual assessments.

**The National Psychosis Unit will no longer be overseen by the Croydon and BDP directorate as of July 3, 2023. The PMOA Directorate will oversee the clinical and operational management of the unit**

  • Service Borough Covers: National (Adult services) Treatment type: Outpatient
  • Contact the service

    Site Location: Bethlem Royal Hospital Email: Phone Number: 020 3228 4322 or 020 3228 4276
  • Disabled Access:


  • Address: National Psychosis Unit
    Fitzmary 2
    Bethlem Royal Hospital Monks Orchard Road
    BR3 3BX
  • Business Hours/Visiting Hours:

    24 hour inpatient unit

  • Other essential information

  • Conditions: schizo-affective disorder, schizoaffective disorder, Addictions, Anxiety, Attention deficit hyperactivity disorder (ADHD), Autism, Bipolar disorder, Body dysmorphic disorder (BDD), Childhood degenerative disorders, Conduct disorder, Dementia, Depression, Dissociative disorders, Eating disorders, Learning disabilities, Neuropsychiatry, Obsessive compulsive disorder (OCD), Perinatal disorders, Persistent physical symptoms, Personality disorders, Post-traumatic stress disorder (PTSD), Psychosexual, Psychosis, Self-harm


Outpatient service

  • An evidence-based assessment in the Maudsley Outpatients Department, by teleconference, video-link or on site at the patient’s local hospital, followed by in-depth discussion at our multidisciplinary expert panel to inform recommendations for further investigation and management
  • Report with clearly defined treatment recommendations for local service providers, aiming to reduce disabling symptoms and improve daily functioning and quality of life
  • Joint assessments with children’s services for adolescents with treatment resistant psychosis
  • Family work

Eligibility criteria


  • 18 years and older
  • Male or female
  • A diagnosis, or suspected diagnosis of psychosis or refractory mania
  • Engagement and support from the local CMHT and responsible clinician

There are no exclusion criteria for our outpatient or outreach service. However, if the psychiatrist receiving the referral believes that another team may better meet the patient’s needs, this will be discussed with the referring clinician.


Our published outcomes are world class, demonstrating clinical excellence:

  • Reduction in psychosis
  • Improved quality of life
  • Reduced overall care costs
  • Expanded discharge destination options
  • Less frequent episodes of illness
  • Improved social functioning
  • Improved engagement with treatment plans
  • Improved understanding of illness by the patient and carers
  • Better physical healthcare leading to reduced morbidity
  • Fewer mental health admissions and bed days
  • Fewer in-patient days in physical health hospitals
  • Reduction in the total number of in-patient days
  • Reduction in level of support required

Read more in these research articles:

Krivoy et al, 2019
Sarkar et al, 2014 
Tracy et al, 2015 
Casetta et al, 2020

While almost all out inpatients come from acute inpatient or PICU settings, they are predominantly discharged to the community or to rehabilitation settings (Casetta et al 2020, in press: real-world-effectiveness-of-admissions-study.pdf).

Care Options


Care option: Psychosis – Outpatient Assess (A) 
Code: 40301 

Care option: SF Psychosis – Outpatient Assess (A) 
Code: 92807 


Care option: Psychosis – outreach assess local (A)
Code: 53991 



Our clinicians offer education and training in the assessment and management of difficult to treat psychosis. This is available for individuals or small groups of professionals or may be extended as an outreach package for team-based training of larger groups. In addition, for those wishing to develop refractory psychosis services, consultations are provided to clinicians, managers and commissioners. The programme delivers the following outcomes:

  • Develops an understanding of the theoretical principles that underpin the effective assessment and management of resistant psychosis
  • Increases clinicians’ competence and confidence in the assessment and management of resistant psychosis
  • Explores ways in which psychopharmacological and psychotherapeutic skills can be combined with knowledge of emerging treatment strategies in resistant psychosis, including how to optimise clozapine treatment and reduce the medical risk associated with persistent psychosis 

Our experts

Our experts include some of the most highly cited in our field worldwide. Our focus on treatment resistant psychosis over three decades has enabled us to become a world class centre of excellence in this field. For instance, our research group on the antipsychotic drug clozapine is the most highly cited worldwide.

Prof Fiona Gaughran: Read more

Prof James MacCabe: Read more

Prof Sir Robin Murray: Read more

Prof David Taylor: Read more

Eromona Whiskey: Read more

Dr Maria Antonietta Nettis: Read more

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