Tognin Stefania, Grady Lara, Ventura Serena, Valmaggia Lucia, Sear Victoria, McGuire Philip, Fusar-Poli Paolo, Spencer Tom J
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
Front Psychiatry. 2019 Nov 8;10:799. doi: 10.3389/fpsyt.2019.00799. eCollection 2019.
Clinical services for the early detection of individuals at clinical high risk of psychosis, such as Outreach and Support in South-London (OASIS), have been successful in providing psychological intervention and psychosocial support to young people experiencing emerging signs of serious mental disorders. Despite this, several studies have repeatedly shown that vocational and functional recovery in the clinical high risk for psychosis population is still low. This study aimed at evaluating the presence and nature of educational and employment focused interventions within the OASIS service, in order to inform research and clinical interventions aimed at supporting young people with early signs of psychosis on their path to vocational recovery. The specific objectives were to compare current practice i) to standards defined by the National Institute of Care Excellence guidelines; and ii) to principles defined by Individual Placement and Support (IPS). Nine standards of practice were derived. The OASIS caseload electronic records entered between January 2015 and January 2017 were manually screened. Data collected include sociodemographic, assessment of employment and educational status and support needs, interventions received, contacts with schools, employers and external vocational providers, employment, and educational status. Standards were considered as "met" if they were met for at least 90% of clients. Results suggest that, two out of nine standards were met while the remaining standards were only partially met. In particular, support provided was always focused on competitive employment and mainstream education and support was always based on people's interest. Implications for clinical and research practice are discussed.
针对临床高危精神病个体的早期检测临床服务,如伦敦南部的外展与支持服务(OASIS),已成功地为出现严重精神障碍新迹象的年轻人提供心理干预和社会心理支持。尽管如此,多项研究反复表明,精神病临床高危人群的职业和功能恢复率仍然很低。本研究旨在评估OASIS服务中以教育和就业为重点的干预措施的存在情况和性质,以便为旨在支持有精神病早期迹象的年轻人走上职业康复道路的研究和临床干预提供信息。具体目标是将当前做法与以下两项进行比较:i)国家医疗保健卓越研究所指南定义的标准;ii)个人安置与支持(IPS)定义的原则。得出了九条实践标准。对2015年1月至2017年1月期间录入的OASIS病例电子记录进行了人工筛查。收集的数据包括社会人口统计学信息、就业和教育状况评估以及支持需求、接受的干预措施、与学校、雇主和外部职业服务提供商的联系、就业和教育状况。如果至少90%的客户符合标准,则认为标准得到了“满足”。结果表明,九条标准中有两条得到了满足,其余标准仅部分得到满足。特别是,提供的支持始终侧重于竞争性就业和主流教育,并且支持始终基于人们的兴趣。讨论了对临床和研究实践的启示。