Assertive Outreach is the treatment of choice for the severely mentally ill in the community. It involves taking services to the patients rather than requiring them to attend hospitals and clinics. The model is one of a high staff-to-patient ratio offering comprehensive health and social care. Assertive Outreach is a targeted and refined application of the existing practice of community mental health teams - an evolution of community policy rather than a revolutionary change. Research evidence and outcome data suggests it results in reduced hospitalizations, promotes effective engagement with difficult patients and improves patient wellbeing. As a policy, it has been implemented successfully in Australia, the USA and Europe, and it is now being adopted nationally in the UK. This book will equip all members of the multidisplinary Assertive Outreach team with a clear understanding of the essential processes and interventions involved. Tom Burns and Mike Firn are pioneers in this field and have been running an Assertive Outreach team for seven years. They have been awarded Beacon status by the UK Department of Health to reflect their excellence, and are heavily involved in teaching others setting out on the same path.
Readership: All members of the multidisciplinary community mental health team - psychiatrists, clinical psychologists, psychiatric nurses, social workers and occupational therapists; as well as health policy specialists and service managers.
Tom Burns, Department of Psychiatry, St George's Hospital Medical School, London, and Mike Firn, Assertive Community Treatment Team, London
"The authors have produced a clear and readable text which dispenses good practical information . . . This book will be invaluable to practitioners and students alike and should be considered essential reading for anyone working in or alongside assertive outreach services." - British Journal of Occupational Therapy
"Burns and Firn's book is a comprehensive guide to assertive outreach practice, and is essential reading for anyone working in this specialism." - Red Journal
"Assertive outreach is a central plank of the government's mental health care reforms, yet we still lack any clear definition of its role in relation to other forms of care. Burns and Firn's book is thus very timely." - Mental Health Today
". . . the strength of the book lies in its open and honest discussion of the problems that are faced by mental health professionals working in community settings. The authors set out to reflect issues that concern multidisciplinary teams on a day-to-day basis, and this is exactly what they have succeeded in doing. The book is filled with interesting observations and sound advice." - Psychological Medicine, 33
Part One - Conceptual Issues 1: Origins of assertive outreach 2: Current context and aims 3: Who is assertive outreach for? Referrals and discharges 4: Ingredients and standards (model fidelity) 5: Key working versus the 'team approach' 6: 24-hour availability and extended services 7: The role of medication 8: Compulsion and freedom 9: Cultural sensitivity Part Two - Health and Social Care Practice 10: Engagement 11: Medication compliance 12: Hostility 13: Suicidality 14: Self-neglect 15: Schizophrenia and delusional disorders 16: Bipolar affective disorder 17: Personality problems and disorders 18: Depression, anxiety and situational disorders 19: Substance abuse 20: Personal finance 21: Housing and homelessness 22: Physical health care 23: Employment and activity 24: Daily living skills 25: Psychosocial interventions and work with families and carers Part Three - Structural Issues 26: Managing the team 27: Training 28: Service planning 29: Research and development References
