ASSERTIVE OUTREACH IN THE NORTH

The service model most widely evaluated as a means of engaging adults with severe mental illness who do not readily maintain contact with services has been assertive community treatment. On the basis of US evidence that higher fidelity to the model is associated with better outcomes for users, the staffing and activity of these teams was precisely defined by the English Department of Health as part of the implementation programme.

This is a longitudinal study of the implementation of assertive outreach in North East England. Data were collected at two time-points T1 (2002/3) and T2 (2005/6). Standardised measures were employed to assess assertive outreach team organisation and the characteristics and mental health of service users. In the three years, the number of teams increased from 27 to 34. Over 800 service users were assessed in 2002/3 (87% response).

Three years on, the teams had almost doubled their capacity to around 1500 users. The study is examining the teams’ evolution in terms of staffing, services, fidelity to the prescribed service model and changes in case mix. We are studying three year outcomes for service users, including hospital admissions, psychiatric symptoms and social functioning.