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 12:1 intensity of service. Frequency of contact. Daily team meeting. Regular formal MDT meeting Team approach. Team leader / Manager /Care Co-ordinator Responsible 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