North Birmingham assertive outreach evaluation

Background Given the adoption of assertive outreach teams into UK mental health policy, it is important to assess whether gains identified in efficacy studies can be replicated in ordinary clinical settings. Aim The aim of the study was to assess patient characteristics and clinical outcomes in routine assertive outreach services in the UK. Methods Patients (N=250), newly taken onto five assertive outreach teams, were followed up over 2 years. Baseline characteristics and outcome measures were compared. Results Most patients had an International Statistical Classification of Diseases and Related Health Problems, 10th Revision, diagnosis of schizophrenia, schizotypal or delusional disorder and long-standing involvement with psychiatric services. Around a half had a history of substance abuse and violence. At follow-up, the majority had ongoing input from the teams and there was a significant decrease in the use of in-patient care. There was no improvement in symptoms, risk behaviours or social functioning. Conclusions Patients on assertive out reach teams remain in contact with services and spend less time in hospital yet show little change with respect to clinical outcomes.