Presentation Transcript

1. Assertive Outreach

2. What is it ?Assertive outreach is a community based service for adults suffering from a severe and persistent mental health problem with complex needs, who have difficulty engaging with other mental health services and as a consequence often leads to repeat hospital admission .(See Stein & Test 1980. & Teague, Bond,& Drake 1998)
3. How does it operate ?Explicit admission criteria.Small caseload 12:1intensity of service.Frequency of contact.Daily team meeting.Regular formal MDT meetingTeam approach.Team leader / Manager /Care Co-ordinatorResponsible for admission and discharge.Provision of care where clients are.Links to 24 hour cover. ( Core Criteria for the achievement of Assertive Outreach in the South West: Steve Onyett CSIP)
4. How do we do in Cornwall ?Not bad.We have :-An explicit admission criteria.Small caseloads. Every client will know at least 4 team members who will know their care-plan.flexible to be intensive and frequent if needed.Meet daily / telephone conference.Weekly MDT review of all clients.Team leader has a caseload.We see people where they want to be seen.We work with Home treatment team and out of hours to deliver 24 hour support.10/12 – ain’t bad
5. What is the Future for AOT Integration into a recovery service FACT ( function-ACT) ?
6. Refs Miller & Rollnick 2002. Motivational interviewing (preparing people for change) 2nd Ed Guilford press. ISBN 1-57230-563-0 Dukker et al. a real life observational study of the effectiveness of FACT in a Dutch mental health region. BMC Psychiatry 2008 8.93 Killaspy et al . REACT study: Randomised evaluation of ACT in North London. (BMJ 2006 322. 815-820) Stein & Test. Alternatives to mental hospital treatment 1: Conceptual model, treatment program & clinical evaluation ,1980. Arch Gen Psychiatry 37 392-397. Teague, Bond & Drake : 1998 . Program fidelity in ACT, Development & use of a measure. American Journal of Orthopsychiatry 68(2) pp 216-232