scholarly journals Assertive community treatment in UK practice

2005 ◽  
Vol 11 (6) ◽  
pp. 388-397 ◽  
Author(s):  
Andrew Kent ◽  
Tom Burns
Keyword(s):  
Social Functioning ◽  
Assertive Community Treatment ◽  
Individual Case ◽  
Community Treatment ◽  
Team Members ◽  
Clozapine Treatment ◽  
Wide Range ◽  
The Uk ◽  
Poor Medication Adherence

Since 2000 assertive outreach has been a requirement of community mental health provision in the UK. This has led to rapid proliferation of assertive community treatment teams offering a pure form of clinical case management to people with severe mental illness. The teams provide intensive support in obtaining material essentials such as food and shelter and place a greater emphasis on social functioning and quality of life than on symptoms. People with psychotic illness with fluctuating mental state and social functioning and poor medication adherence are most likely to benefit. Teams are ideally placed to monitor clozapine treatment in the community. Teams require a broad skills mix, and team members need some competence across a wide range of areas. Teams should include a psychiatrist or have regular access to one. Ideal individual case-loads are 10–12 patients. Around-the-clock availability is no longer considered essential, particularly in view of the rise of crisis resolution/home treatment teams.

scholarly journals Setting up an assertive community treatment service

1996 ◽  
Vol 2 (4) ◽  
pp. 143-150 ◽  
Author(s):  
Andrew Kent ◽  
Tom Burns
Keyword(s):  
Assertive Community Treatment ◽  
Mentally Ill ◽  
Revolving Door ◽  
Community Treatment ◽  
Treatment Service ◽  
Flexible Support ◽  
Severely Mentally Ill ◽  
Functional Areas ◽  
Key Worker

The last 20 years have witnessed a surge of interest in assertive community treatment (ACT) for the severely mentally ill (Drake & Burns, 1995). ACT aims to help people who would otherwise be in and out of hospital on a ‘revolving door’ basis live in the community and enjoy the best possible quality of life. Services based on the ACT model seek to replace the total support of the hospital with comprehensive, intensive and flexible support in the community, delivered by an individual key worker or core services team. They are organised in a way that optimises continuity of care across different functional areas and across time.

The evolution of community outreach

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Assertive Community Treatment ◽  
Multidisciplinary Team ◽  
Care Management ◽  
Community Outreach ◽  
Radical Change ◽  
Community Treatment ◽  
Team Approach ◽  
Wide Range ◽  
The Us ◽  
Institutionalized Patients

This chapter traces the origin of the multidisciplinary team as a response to the wide range of needs of deinstitutionalized and ‘never institutionalized’ patients as care has become established in the community. It charts the early pragmatic and local evolution of CMHTs and case management and care management. It outlines how this was followed by a radical change around 1980 with the first published studies of assertive community treatment (ACT) in the US. A more rigorous, theoretically informed, and international research driven approach has become the norm. This has explored the relevance or otherwise of several of the underlying principles such as the team approach and 24-hour availability.

scholarly journals S33. RELATIVES IN RESOURCE GROUP ASSERTIVE COMMUNITY TREATMENT (RACT): RELATIVES’ EXPERIENCES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S44-S44
Author(s):  
Nils Sjöström ◽  
Mats Ewertzon ◽  
Ola Johansson ◽  
Bente Weimand ◽  
Anita Johansson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Assertive Community Treatment ◽  
Psychotic Disorders ◽  
Healthcare Professionals ◽  
Self Report ◽  
Community Treatment ◽  
Family Burden ◽  
Next Of Kin ◽  
Resource Group

Abstract Background Relatives often provide extensive support to their next of kin suffering from psychotic disorders. However, they often experience lack of support from psychiatric services. While cooperation with relatives is a central component in Resource Group Assertive Community Treatment (RACT), little is known about relatives’ experiences of RACT. The aim was to investigate relatives’ experiences of encountering psychiatric care with and without RACT, in relation to quality of life, family burden and family stigma. Methods A total of 139 relatives of individuals suffering from psychotic disorders in the Region Västra Götaland, Sweden filled out the self-report instruments Family Involvement and Alienation Questionnaire – Revised (FIAQ-R), the Burden Inventory for Relatives of Persons with Psychotic Disturbances, the Inventory of Stigmatizing Experiences (family version), and RAND-36. Results Participants included 79 relatives with experience of RACT and 60 without. In the total group 70% were women. Mean age was 63 years (SD 12.4). A majority came from Sweden (91%), had >12 years of education (61%) and did not live together with the patient (76%). A majority were parents, (70%). These demographic characteristics did not differ in those with and without RACT. We found that relatives who participated RACT experienced a more positive approach from the healthcare professionals compared to those without RACT (p=.001). Furthermore, relatives who participated in RACT felt to a lower extent that they were alienated from the provision of care than did other relatives (p=.005). Relatives who did not participate in resource group were significantly more afraid that their ill next of kin would hurt someone. The association remained after adjustment for experience of approach and feeling of alienation. No other differences in family burden variables were found. Findings regarding mental Quality of Life scores and experiences of family stigmatization were similar in those both with and without RACT. Discussion The results suggest that participating in RACT may contribute to a higher level of satisfaction for relatives in their encounter with healthcare professionals.

scholarly journals A visitor's view of Madison's Program for Assertive Community Treatment (PACT)

1989 ◽  
Vol 13 (7) ◽  
pp. 352-355 ◽  
Author(s):  
M. Muijen ◽  
G. McNamee
Keyword(s):  
Mental Health ◽  
Assertive Community Treatment ◽  
Community Care ◽  
Research Programme ◽  
Community Treatment ◽  
Positive Research ◽  
Schizophrenic Patients ◽  
Research Findings ◽  
Long Term Prognosis ◽  
The Uk

Before commencing work on the Daily Living Programme at the Maudsley Hospital, in London, to compare the benefits of community care with standard hospital admission for patients with serious mental illness, a visit to Madison was arranged, where some ten years ago a similar study had been carried out (Stein & Test, 1980). We had the impression from the substantial literature which has appeared on the mental health service in Madison (Stein & Test, 1985) that they have implemented in practice their positive research findings on community care. It was felt that their lengthy experience with such a service could be beneficial to the UK, where such services are now being developed. This visit included PACT (Program for Assertive Community Treatment); a research programme investigating the long-term prognosis of mainly schizophrenic patients, and the various units of the mental health services in Madison.

scholarly journals 520 - Benefits of Assertive Community Treatment for Persons with Severe Mental Illness and Cancer

2021 ◽  
Vol 33 (S1) ◽  
pp. 69-69
Author(s):  
Monica Taylor-Desir
Keyword(s):  
Breast Cancer ◽  
Mental Illness ◽  
Cancer Treatment ◽  
Severe Mental Illness ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Case Vignette ◽  
Treatment Team ◽  
Assertive Community Treatment Team

Breast cancer, the most commonly diagnosed cancer in women worldwide, is responsible for one in six cancer deaths (Sung, H. et al., 2021). Women with schizophrenia have an associated increased incidence of breast cancer compared to the general population (Grassi & Riba, 2020). Patients with severe mental illness are noted to have disparities in accessing and initiating cancer treatment especially among those who are older (Iglay et al., 2017). A case vignette will be presented to illustrate the care and interventions provided by an American Assertive Community Treatment team which fostered supportive treatment engagement and improved the quality of life for a patient that chose to forgo recommended cancer treatment. This presentation will highlight the essential nature of the Assertive Community Treatment team in supporting decisional capacity, facilitation of a patient’s grief and acknowledgement of one’s own mortality as well as incorporation of medical and palliative care. The attendee will appreciate the importance of the multidisciplinary approach for persons with chronic mental illness and co-morbid cancer diagnoses.

The Role of Illness Identity in Assertive Community Treatment

2019 ◽  
Vol 63 (4) ◽  
pp. 216-223 ◽  
Author(s):  
William R. Waynor ◽  
SunHee J. Eissenstat ◽  
Phillip T. Yanos ◽  
Dawn Reinhardt-Wood ◽  
Ellen Taylor ◽  
...  
Keyword(s):  
Assertive Community Treatment ◽  
Self Efficacy ◽  
Psychiatric Hospitalization ◽  
Psychiatric Symptoms ◽  
Community Mental Health Services ◽  
Community Treatment ◽  
Internalized Stigma ◽  
Team Members ◽  
Work Related

Assertive community treatment (ACT) provides comprehensive clinical services, including vocational rehabilitation, to individuals with psychiatric disorders for which traditional community mental health services are insufficient. ACT is an evidence-based intervention yielding many positive outcomes, yet service recipients continue to struggle with workforce involvement. The purpose of this study is to determine whether internalized stigma, psychiatric hospitalization, and psychiatric symptoms are associated with work-related self-efficacy among ACT service recipients. A total of 72 individuals with severe mental illness were recruited from ACT programs in three counties in a Mid-Atlantic state. Multiple linear regression was conducted to examine the relationship between work-related self-efficacy and the independent variables of internalized stigma, psychiatric hospitalization, and psychiatric symptoms. Higher internalized stigma scores were negatively associated with work-related self-efficacy (β = −.31, t = −2.32, p < .05), while psychiatric hospitalization in the past year was positively associated with work-related self-efficacy (β = .22−.27, t = −2.13, p < .05). Findings from this study suggests internalized stigma to be an important recovery variable requiring the attention of ACT team members when preparing individuals for work, while countering the assumption that recent hospitalization is a barrier to work-related self-efficacy.

scholarly journals What are the Prerequisites for Good Clinical Practice in Europe?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Bhugra
Keyword(s):  
Social Sciences ◽  
Good Clinical Practice ◽  
Strategic Thinking ◽  
Leadership Teams ◽  
Good Doctor ◽  
Team Members ◽  
Good Medical Practice ◽  
Raising Awareness ◽  
The Uk

Good Medical Practice and Good Psychiatric Practice are key documents in the UK, indicating characteristics of a good doctor and a good psychiatrist respectively. Individual aspects of what constitutes a professional can be seen in relationship with other disciplines, team members and stakeholders. A key task of any organisation that purports to speak for the profession is to identify what these qualities are, how they are to be inculcated and developed. The Royal College of Psychiatrists, therefore, is in a unique position to do this and take it forward without guilt and shame. Leadership, teams, education, appraisals, careers and research are themes which have to be looked at. For any leadership to be successful it must have vision, strategic thinking, motivation and trust, all of which are being challenged at present. The profession of psychiatry must move from nostalgic professionalism to ‘new’ professionalism. of We as psychiatrists must ascertain our civic and fiduciary responsibilities by identifying and agreeing standards of quality of care, altruism and values of the profession identified by us and worked at with other stakeholders. The primacy of patient welfare and advocacy for our patients is critical. For our medical-moral interdependence we must be honest with ourselves as to what our strengths and weaknesses are, but also with society to declare what we can deliver in reality and what our aspirations are. Courses in ethics, humanities and human values (medical history, social sciences, literature and films) can sensitize the clinician by raising awareness and developing critical reflection.

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