New approach on mental health care reduced hospital admissions

A novel way of delivering mental health care imported from the USA has reduced the need for hospital admissions for people with psychosis, according to University of York researchers.

But the study of the impact of the Assertive Outreach teams, led by Ian Hamilton, a lecturer in the University’s Department of Health Sciences, found that hospital admissions for people with psychosis tended to increase in the summer months and in July in particular.

The Health Sciences research team, which included senior lecturer Charlie Lloyd, Professor of Health Statistics Martin Bland and Senior Mental Health Lecturer Anita Savage Grainge, found that the Department of Health’s investment in the Assertive Outreach model by was justified.

Assertive Outreach is a novel way of delivering mental health care for people with severe mental health problems such as schizophrenia and psychosis. The model includes:

• Small case loads
• Flexible ways of meeting clients
• Extended hours of operation, including weekends
• Creative ways to engage clients who have disengaged from services

By 2003, the Department of Health had rolled out 220 Assertive Outreach teams in community mental health services across England. But their introduction lacked any evidence that the positive impact they produced in America would translate to the UK.

Ian Hamilton said: “Despite international evidence supporting the Assertive Outreach Model there had been no large scale evaluation of its impact in the UK. Our study was the first to use a large data set to show that Assertive Outreach Teams have reduced the need for hospital admissions for people with psychosis so, by this outcome, the investment made by the Department of Health was justified.

“Surprisingly we also found a consistent seasonal pattern to admissions, with recurring peaks in the summer months – July in particular – and a decline in the winter ones. This has clear implications for both community and hospital workforce planning.”