Skip to main content
×
×
Home

Assertive outreach teams in London: Models of operation: Pan-London Assertive Outreach Study, Part 1

  • Christine Wright (a1), Tom Burns (a2), Peter James (a3), Joanne Billings (a4), Sonia Johnson (a3), Matt Muijen (a5), Stefan Priebe (a6), Iain Ryrie (a6), Joanna Watts (a6) and Ian White (a6)...
Abstract
Background

Assertive outreach teams have been introduced in the UK, based on the assertive community treatment (ACT) model. It is unclear how models of community care translate from one culture to another or the degree of adaptation that may result.

Aims

To characterise London assertive outreach teams and determine whether there are distinct groups within them.

Method

Semi-structured interviews with team managers plus one month's prospective process of care data collection were used to test for ‘model fidelity'to ACT and, by cluster analysis, to identify groupings.

Results

Fidelity varied widely, with four teams (out of 24 studied) rated ‘high fidelity’ and three teams rated ‘low fidelity’ by US standards and 17 rated ‘ACT-like’. Three clusters were identified, with voluntary sector teams being the most distinct group.

Conclusions

There is wide variation in the practice of assertive outreach in London. The role of the voluntary sector requires increased attention. Heterogeneity in practice is a clinical challenge but a research opportunity in distinguishing effective from redundant components of the approach.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Assertive outreach teams in London: Models of operation
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Assertive outreach teams in London: Models of operation
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Assertive outreach teams in London: Models of operation
      Available formats
      ×
Copyright
Corresponding author
Dr Christine Wright, Social and Community Psychiatry, Departmentof Mental Health, St George's Hospital Medical School, Cranmer Terrace, Tooting, London SWI7 0RE, UK. E-mail: cwright@sghms.ac.uk
Footnotes
Hide All

See Parts 2 and 3, pp. 139–154, this issue.

Declaration of interest

Funding provided by the Department of Health.

Footnotes
References
Hide All
Burns, T., Creed, F., Fahy, T., et al (1999) Intensive versus standard case management for severe psychotic illness: a randomised trial. Lancet, 353, 21852189.
Burns, T., Fiander, M., Kent, A., et al (2000) Effects of caseload size on the process of care of patients with severe psychotic illness. Report from the UK700 trial. British Journal of Psychiatry, 177, 427433.
Burns, T., Knapp, M., Catty, J., et al (2001) Home treatment for mental health problems: a systematic review. Health Technology Assessment, 5, no. 15. http://www.hta.nhsweb.nhs.uk/fullmono/mon5l5.pdf
de Jong, A. (1996) International Classification of Mental Health Care. Groningen: Department of Social Psychiatry, University of Groningen and the World Health Organization.
Department of Health (1999) The National Service Framework for Mental Health. London: Department of Health.
Department of Health (2001) The Mental Health Policy Implementation Guide. London: Department of Health.
Everitt, B., Landau, S., Leese, M., et al (eds) (2001) Cluster Analysis (4th edn). London: Edward Arnold.
Ford, R., Repper, J., Cooke, A., et al (1993) Research Report on the Process of Developing Case Management Services for People with a Long-term Mental Illness. London: Research and Development for Psychiatry.
Johnson, S., Zinkler, M. & Priebe, S. (2001) Mental health service provision in England. Acta Psychiatrica Scandinavica, 104 (suppl. 410), 4755.
Marshall, M., Bond, G., Stein, L.I., et al (1999) PRiSM Psychosis Study: design limitations, questionable conclusions. British Journal of Psychiatry, 175, 501503.
Stein, L. I. & Test, M. A. (1980) Alternative to mental health treatment: conceptual model, treatment program and clinical evaluation. Archives of General Psychiatry, 37, 392397.
Teague, G. B., Bond, G. R. & Drake, R. E. (1998) Program fidelity in assertive community treatment: development and use of a measure. American Journal of Orthopsychiatry, 68, 216232.
Thornicroft, G., Wykes, T., Holloway, F., et al (1998) From efficacy to effectiveness in community mental health services. PRiSM Pschosis Study 10. British Journal of Psychiatry, 173, 423427.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 30 *
Loading metrics...

Abstract views

Total abstract views: 120 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 26th May 2018. This data will be updated every 24 hours.

Assertive outreach teams in London: Models of operation: Pan-London Assertive Outreach Study, Part 1

  • Christine Wright (a1), Tom Burns (a2), Peter James (a3), Joanne Billings (a4), Sonia Johnson (a3), Matt Muijen (a5), Stefan Priebe (a6), Iain Ryrie (a6), Joanna Watts (a6) and Ian White (a6)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *