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Service innovation: assertive outreach teams for adults with learning disability

  • Jamuna Prakash (a1), Tim Andrews (a2) and Ian Porter (a3)
Extract

Assertive community treatment (ACT) was developed in the early 1970s as a means of coordinating the care of people with severe mental illness in the community. A Cochrane review of the effectiveness of ACT for the general adult population found that people receiving ACT were more likely to engage with services, and were less likely to be admitted to hospital (Marshall & Lockwood, 2000). The National Service Framework for Mental Health (Department of Health, 1999) and the NHS Plan (Department of Health, 2000) called for a total of 220 assertive outreach teams by April 2003.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Deb, S., Thomas, M. & Bright, C. (2001) Mental disorder in adults with intellectual disability: prevalence of functional psychiatric illness among a community-based population aged between 16 and 64 years. Journal of Intellectual Disability Research, 45, 495505.
Department of Health (1999) National Service Framework for Mental Health. Department of Health.
Department of Health (2000) The NHS Plan. The Government's Response to the Royal Commission on Long-Term Care. Department of Health.
Gustafsson, C. (1997) The prevalence of people with intellectual disability admitted to general hospital psychiatric units: level of handicap, psychiatric diagnoses and care utilization. Journal of Intellectual Disability Research, 41, 519526.
Hassiotis, A., Ukoumunne, O. C., Byford, S., et al (2001) Intellectual functioning and outcome of patients with severe psychotic illness randomised to intensive case management. Report from the UK700 trial. British Journal of Psychiatry, 178, 166171.
Hassiotis, A., Tyrer, P. & Oliver, P. (2003) Psychiatric assertive outreach and learning disability services. Advances in Psychiatric Treatment, 9, 368373.
Marshall, M. & Lockwood, A. (2000) Assertive community treatment for people with severe mental disorders. Cochrane Library. Update Software.
Meisler, N., McKay, C. D., Gold, P. B., et al (2000) Using principles of ACT to integrate community care for people with mental retardation and mental illness. Journal of Psychiatric Practice, 6, 7788.
Moss, S., Prosser, H., Costello, H., et al (1998) Reliability and validity of the PAS–ADD Checklist for detecting psychiatric disorders in adults with intellectual disabilities Journal of Intellectual Disability Research, 42, 173183.
Oliver, P. C., Piachaud, J., Tyrer, P., et al (2005) Randomized controlled trial of assertive community treatment in intellectual disability: the TACTILD study. Journal of Intellectual Disability Research, 49, 507515.
Porter, I. & Sangha, J. (2002) Reaching out. Learning Disability Practice, 5, 1821.
Roy, A., Mathews, H., Clifford, P., et al (2002) The Health of the Nation Outcome Scales for People with Learning Disabilities. Royal College of Psychiatrists.
Sainsbury Centre for Mental Health (2001) Mental Heath Topics: Assertive Outreach. Sainsbury Centre for Mental Health.
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Thiru, S., Hayton, P. & Stevens, E. (2002) Assertive outreach. Learning Disability Practice, 5, 1013.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Service innovation: assertive outreach teams for adults with learning disability

  • Jamuna Prakash (a1), Tim Andrews (a2) and Ian Porter (a3)
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eLetters

Re: Assertive outreach teams for adults with learning disability

Justin C Marley, Specialist Registrar in General Adult Psychiatry
02 May 2007

Dear Editor,

I read with interest Prakash et al's (Prakash et al, 2007) article onan assertive outreach team for adults with Learning Disabilities. My initial response was one of scepticism given the ratio of 2 patients to every staff member (excluding the psychiatrist). On further reflection however the skills of this team may be of great benefit in additionally addressing the needs of those that fall just above the learning disabilityrange including those with Asperger Syndrome. Having worked in both Learning Disability and General Adult Services my experience is that the psychiatric needs of this group are not easily addressed by services and similar comments have been made elsewhere (Chaplin and Flynn, 2000). Finally, have capacity assessments and utilisation of advocacy services been of use in overcoming the stated boundary issues?

Yours sincerely

Dr Justin Marley(Specialist Registrar in General Adult Psychiatry)

References

Chaplin, R and Flynn, R. (2000) Adults with learning disability admitted to psychiatric wards. Advances in Psychiatric Treatment, 6, 128-134.

Prakash.J, Andrews.T and Porter.I. (2007) Service Innovation: assertive outreach teams for adults with learning disability. Psychiatric Bulletin. 31, 138-141.
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