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Assertive outreach teams in London: Patient characteristics and outcomes: Pan-London Assertive Outreach Study, Part 3

  • Stefan Priebe (a1), Walid Fakhoury (a2), Joanna Watts (a3), Paul Bebbington (a2), Tom Burns (a4), Sonia Johnson (a5), Matt Muijen (a3), Iain Ryrie (a3), Ian White (a3) and Christine Wright (a3)...
Abstract
Background

Although the model of assertive outreach has been widely adopted, it is unclear who receives assertive outreach in practice and what outcomes can be expected under routine conditions.

Aims

To assess patient characteristics and outcome in routine assertive outreach services in the UK.

Method

Patients (n=580) were sampled from 24 assertive outreach teams in London. Outcomes – days spent in hospital and compulsory hospitalisation – were assessed over a 9-month follow-up.

Results

The 6-month prevalence rate of substance misuse was 29%, and 35% of patients had been physically violent in the past 2 years. During follow-up, 39% were hospitalised and 25% compulsorily admitted. Outcome varied significantly between team types. These differences did not hold true when baseline differences in patient characteristics were controlled for.

Conclusions

Routine assertive outreach serves a wide range of patients with significant rates of substance misuse and violent behaviour. Over a 9-month period an average of 25% of assertive outreach patients can be expected to be hospitalised compulsorily. Differences in outcome between team types can be explained by differences in patient characteristics.

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Copyright
Corresponding author
Professor Stefan Priebe, Unitfor Social and Community Psychiatry, Newham Centre for Mental Health, London EI3 8SP, UK. E-mail: s.priebe@qmul.ac.uk
Footnotes
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See Parts 1 and 2, pp. 132–147, this issue.

Declaration of interest

Funding provided by the Department of Health.

Footnotes
References
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American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.
Bhui, K., Stansfeld, S., Hull, S., et al (2003) Ethnic variations in pathways to and use of specialist mental health services in the UK. Systematic review. British Journal of Psychiatry, 182, 105116.
Billings, J., Johnson, S., Bebbington, P., et al (2003) Assertive outreach teams in London: staffexperiences and perceptions. Pan-London Assertive Outreach Study, Part 2. British Journal of Psychiatry, 183, 139147.
Bond, G. R., Witheridge, T. F., Dincin, J., et al (1990) Assertive community treatment for frequent users of psychiatric hospitals in alarge city: acontrolled study. American Journal of Community Psychology, 18, 865891.
Burns, T., Creed, F., Fahy, T., et al (1999) Intensive versus standard case management for severe psychotic illness: a randomised trial. The UK700 group. Lancet, 353, 21852189.
Chandler, D., Meisel, J., McGowen, M., et al (1996) Client outcomes in two model capitated integrated service agencies. Psychiatric Services, 47, 175180.
Department of Health (1999) National Service Framework for Mental Health. London: Departmentof Health.
Drake, R. E., Osher, F. C. & Wallach, M. A. (1989) Alcohol use and abuse in schizophrenia. A prospective community study. Journal of Nervous and Mental Disease, 177, 408414.
Drake, R. E., Osher, F. C., Noordsy, D. L., et al (1990) Diagnosis of alcohol use disorders in schizophrenia. Schizophrenia Bulletin, 16, 5767.
Drake, R. E., Essock, S. M., Shaner, A., et al (2001) Implementing dual diagnosis services for clients with severe mental illness. Psychiatric Services, 52, 469476.
Duke, P. J., Pantelis, C., McPhillips, M. A., et al (2001) Comorbid non-alcohol substance misuse among people with schizophrenia: epidemiological study in central London. British Journal of Psychiatry, 179, 509513.
Essox, S. & Kontos, N. (1995) Implementing assertive community treatment teams. Psychiatric Services, 46, 679693.
Jarman, B. (1983) Underprivileged areas: validation and distribution scores. BMJ, 298, 15871592.
McGrew, J. H., Bond, G. R., Dietzen, J., et al (1995) Amulti-site study of patient outcomes in assertive community treatment. Psychiatric Services, 46, 696701.
Mueser, K.T., Bond, G. R. & Drake, R. E. (1998) Models of community care for severe mental illness: a review of research on case management. Schizophrenia Bulletin, 24, 3741.
Thornicroft, G., Strathdee, G., Phelan, M., et al (1998) Rationale and design. PRiSM Psychosis Study 1. British Journal of Psychiatry, 173, 363370.
Watts, J. & Priebe, S. (2002) A phenomenological account of users' experiences of assertive community treatment. Bioethnics, 16, 439454.
Wright, C., Burns, T., James, P., et al (2003) Assertive outreach teams in London: models of operation. Pan-London Assertive Outreach Study, Part 1. British Journal of Psychiatry, 183, 132138.
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  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Assertive outreach teams in London: Patient characteristics and outcomes: Pan-London Assertive Outreach Study, Part 3

  • Stefan Priebe (a1), Walid Fakhoury (a2), Joanna Watts (a3), Paul Bebbington (a2), Tom Burns (a4), Sonia Johnson (a5), Matt Muijen (a3), Iain Ryrie (a3), Ian White (a3) and Christine Wright (a3)...
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