Understanding the impact of an Assertive Outreach Team on couples caring for adult children with psychosis

2009 ◽  
Vol 31 (3) ◽  
pp. 284-309 ◽  
Author(s):  
Julia Wane ◽  
Michael Larkin ◽  
Megan Earl-Gray ◽  
Hayley Smith
Keyword(s):  
Adult Children ◽  
Assertive Outreach ◽  
Outreach Team ◽  
The Impact

scholarly journals Impact of community treatment orders on inpatient bed usage in assertive outreach team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S233-S234
Author(s):  
Mohammed Al-Uzri ◽  
Zena Harvey ◽  
Fabida Noushad ◽  
Chinyere Iheonu ◽  
Mohammed Abbas
Keyword(s):  
Inpatient Care ◽  
Mean Difference ◽  
Community Treatment ◽  
Controlled Study ◽  
Community Treatment Orders ◽  
Post Discharge ◽  
Assertive Outreach ◽  
Outreach Team ◽  
Bed Days ◽  
The Impact

AimsTo examine the impact of using Communty Treatment Orders (CTO) of the Mental Health Act on use of inpatient care in Assertive Outreach team.BackgroundCurrently there is little evidence of the efficacy of community treatment orders (CTOs), and in particular with patients who use the Assertive Outreach service. One large randomised controlled study found no impact on use of inpatient care while a naturalistc study found significant impact.MethodOur primary outcome was the number of admissions with and without a CTO comparing each patient with themselves before CTO and under CTO(“mirror-image”). Our secondary outcomes were the number of bed days, and the percentage of missed community visits post-discharge. We also looked at the potential cost savings of a reduction in inpatient bed usage.ResultAll the 63 patients studied over period of 6 years had a severe and enduring mental illness. The use of a CTO was linked to a significant reduction in the number of admissions (mean difference = 0.89, 95% CI = 0.53–1.25, P < 0.0001) and bed days (mean difference = 158.65, 95% CI = 102.21–215.09, P < 0.0001) There was no significant difference in the percentage of missed community visits post-discharge. Looking at the costs, an average cost for an inpatient Assertive Outreach bed per day in the local Trust was £250, and there were 8145 bed days saved in total, making a potential saving of just over £2million, during the study period.ConclusionThis study suggests that the implementation of CTOs using clinical judgment and knowledge of patients can significantly reduce the bed usage of Assertive Outreach patients. The financial implications of CTOs need to be reviewed further, but this study does suggest that the implementation of CTOs is a cost-effective intervention and is economically advantageous to the local Trust.

scholarly journals The impact of living arrangements and intergenerational support on the health status of older people in China: are rural residents disadvantaged compared to urban residents?

2021 ◽  
pp. 1-26
Author(s):  
Yazhen Yang ◽  
Maria Evandrou ◽  
Athina Vlachantoni
Keyword(s):  
Life Satisfaction ◽  
Older People ◽  
Adult Children ◽  
Rural Areas ◽  
Living Arrangements ◽  
Psychological Wellbeing ◽  
Urban Residents ◽  
Intergenerational Support ◽  
Rural Residents ◽  
The Impact

Abstract Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

scholarly journals Cervical screening in assertive outreach team patients

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S99-S100
Author(s):  
Hannah Reynolds ◽  
Samaila Bello ◽  
Hanna Leech
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Cervical Screening ◽  
National Standards ◽  
Assertive Outreach ◽  
Complex Needs ◽  
Physical Health Outcomes ◽  
Outreach Team ◽  
West Midlands ◽  
Working Together

AimsTo assess the uptake of cervical screening in patients under Birmingham and Solihull Assertive Outreach Teams; this included a re-audit of patients under the Central Birmingham Assertive Outreach Team.BackgroundPatients with severe and enduring mental illness are known to have poorer physical health outcomes. In Birmingham and Solihull there are 6 Assertive Outreach Teams. These teams manage patients with a diagnosis of psychosis who have complex needs requiring intensive multidisciplinary input and often struggle to engage with health services. The national cervical screening programme aims to prevent cervical cancer by detecting and treating cervical abnormalities. Acceptable coverage is defined as screening at least 80% of people aged 25–49 years within the last 3.5 years and 80% of people aged 50–64 years within the last 5.5 years. In 2018 71.4% of women in England and 70.9% in the West Midlands were screened adequately. An audit of 15 patients under the Central Birmingham Assertive Outreach Team in 2014 showed 46.2% had taken up screening, measured in the last 5 years for those aged 50–64 years and the last 3 years for those aged 25–49 years.MethodA list was obtained of all female patients under the Assertive Outreach Teams with patients excluded if they were under 25 years or over 64 years or if they were known to have undergone a total hysterectomy. All GP practices with eligible patients registered to them were written to requesting the date of the patient's most recent smear test. Cervical screening was classed as in date if carried out in the last 3.5 years for patients aged 25–49 years or 5.5 years for patients aged 50–64 years.ResultOut of 127 eligible patients, 110 had correct GP details on their record. Responses were received regarding 101 patients, 48 of whom had in date cervical screening (47.5%). Of 58 patients aged 25–49 years, 26 had in date cervical screening (44.8%). Of 43 patients aged 50–64 years, 22 had in date cervical screening (51.2%).Conclusion13.4% patients did not have a known GP practice, increasing the risk of multiple poor physical health outcomes. The rates of cervical screening among Assertive Outreach Team patients are similar to the original audit in 2014 and fall significantly below the national standards and averages. These findings, along with the importance of working together to address the need for physical health monitoring in this population, will be communicated with the local Assertive Outreach Teams and GP practices.

scholarly journals Long-term follow-up of individuals on assertive outreach teams

2010 ◽  
Vol 34 (3) ◽  
pp. 88-91 ◽  
Author(s):  
Tanvir Rana ◽  
Martin Commander
Keyword(s):  
Physical Health ◽  
Clinical Implications ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Assertive Outreach ◽  
Admission Rates ◽  
Outreach Team ◽  
Long Term Follow Up

Aims and methodTo describe the long-term outcome of 165 people taken onto assertive outreach teams.ResultsAfter a mean follow-up of 6 years and 8 months, 130 people remained in contact with local services of whom 100 were still under the care of an assertive outreach team. Admission rates remained around half those at inception. However, 16 individuals had died, 10 spent time in prison, 12 were homeless and 14 had protracted stays in hospital during the follow-up period.Clinical implicationsAlthough assertive outreach teams are successful in engaging individuals and reducing admission rates, these benefits plateau after the first few years and could possibly be sustained by other services that may in addition focus more on those areas where teams have proven less effective including physical health, housing and employment.

scholarly journals Salford alcohol assertive outreach team: a new model for reducing alcohol-related admissions

2013 ◽  
Vol 4 (2) ◽  
pp. 130-134 ◽  
Author(s):  
Neill R Hughes ◽  
Natalie Houghton ◽  
Haitham Nadeem ◽  
Jackie Bell ◽  
Suzanne Mcdonald ◽  
...  
Keyword(s):  
New Model ◽  
Assertive Outreach ◽  
Outreach Team

Assertive Outreach Team and Caseload Survey

2005 ◽  
Vol 2 (2) ◽  
pp. 78-94 ◽  
Author(s):  
Jan Slade ◽  
Justine Schneider ◽  
Toby Brandon
Keyword(s):  
Assertive Outreach ◽  
Outreach Team

Establishing and evaluating an assertive outreach team

2013 ◽  
Vol 16 (9) ◽  
pp. 30-34 ◽  
Author(s):  
Emma Louise Douglass ◽  
Barbara Hurtado
Keyword(s):  
Assertive Outreach ◽  
Outreach Team

scholarly journals Aging in Place in Every Community: Social Exclusion Experiences of Parents of Adult children With Autism Spectrum Disorder

2017 ◽  
Vol 40 (6) ◽  
pp. 535-557 ◽  
Author(s):  
Christina N. Marsack ◽  
Tam E. Perry
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Exclusion ◽  
Adult Children ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Parental Caregivers ◽  
Daily Routines ◽  
Caregiving Roles ◽  
The Impact

This article offers an examination of aging processes of lifelong caregivers and the possibilities for social exclusion place experienced by parents of adult children with autism spectrum disorder (ASD). This study of parental caregivers ( n = 51) sheds light on how enduring caregiving roles can lead to social exclusion in three ways: misunderstanding of ASD and stigma, the complexity of the caregiving roles, and impact on daily routines including challenges with long-term planning for both the adult children and the parental caregivers. Implications for practice to address social exclusion include education and building greater communication ties among family member for family members and advocacy for more and higher quality services including respite care. This article concludes with discussion of the impact of this aging, yet caregiving population and the need for knowledge about aging processes and anticipating aging for these caregivers.

scholarly journals Does Informal Care from Adult Children Reduce Nursing Home Admissions for the Elderly?

2002 ◽  
Vol 39 (3) ◽  
pp. 279-297 ◽  
Author(s):  
Anthony T. Lo Sasso ◽  
Richard W. Johnson
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Informal Care ◽  
Adult Children ◽  
Oldest Old ◽  
The Elderly ◽  
Nursing Home Care ◽  
Health Dynamics ◽  
Using Data ◽  
The Impact

Despite the policy importance, particularly as society ages, little is known about the impact of informal care on nursing home admissions. This paper jointly models the receipt of regular help from adult children and subsequent nursing home care, using data from the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD). Results indicate that frequent help from children with basic personal care reduces the likelihood of nursing home use over a subsequent two-year period by about 60% for disabled Americans age 70 and older. However, we found no significant reduction in nursing home admissions when help was measured more broadly to include assistance with chores and errands.

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