A dismantling study of assertive outreach services: comparing activity and outcomes following replacement with the FACT model

Abstract

Enhancing multi-disciplinary CMHTs with FACT provides a clinically effective alternative to AO teams. FACT offers a cost-effective model compared to AO.

The replacement of assertive outreach services by reinforcing local community teams: a four-year observational study

“…In the meantime, financially stretched providers have gradually and quietly closed AO services over the last eight years. A previous paper studied the impact of the closure of two teams in London at 12 months looking at patient outcomes and service utilization (Firn et al, 2013). We reasoned that if AO studies were not showing clinical benefits when moving from standard to specialist team provision, then a further test would be provided by showing that closing AO and reverting to standard care conferred no disadvantage on patients, and might produce cost efficiencies.…”

Integrated Pathways of Care for Psychosis: An Overview

“…While the organization of community care around fi delity to a recognized model had developed in the USA and enabled the use of extensive research in comparing and refi ning service confi gurations or interventions, unfortunately the commissioning of assertive outreach services has not been closely defi ned in the UK, and many opportunities have been missed (Wharne 2013 ). Therefore, in the UK, with the redesigns, remodeling, and constant changes in community services, the majority of assertive outreach teams have been dismantled, with some functions integrated into community mental health teams (Firn et al 2013 ;.…”

A solution to the ossification of community psychiatry

“…23,24 In this model, all elements of good liaison and community care can be combined and deployed when needed, and the clinicians in the services also have a more satisfying working relationship with patients with a greater degree of variety than at present. This does not mean that specialist teams are unnecessary, particularly for some in-patients such as those in longer-term rehabilitation, and for other disorders 25,26 where there is much room for improvement, but for acute care an integrated system makes better use of expertise and brings community and hospital services together.…”