Enhancing the effectiveness of an assertive outreach team : case study

introduced assertive community treatment (assertive outreach) teams in 1999 as part of provision of comprehensive services for the promotion and treatment of mental health. A Cochrane review in 1998 concluded that assertive community treatment was a clinically effective approach to managing the care of people with a severe mental illness in the community. Over the years, researchers have debated the effectiveness of this model as evidence for clinical efficacy varied in different countries. A randomised controlled trial (REACT) involving 251 service users in London failed to show significant differences between assertive community treatment and usual care in in-patient bed use and clinical or social outcomes, but participants found assertive community treatment more acceptable and engaged better with it. These findings, published in 2006, were at 18 months after randomisation. Results at 3 years after randomisation were similar, thereby questioning the continuing investment in assertive community treatment. However, there is evidence that assertive outreach teams are able to maintain engagement with service users and that this model is popular with both staff and service users.