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A comparison of the implementation of assertive community treatment in Melbourne and London

Published online by Cambridge University Press:  24 June 2014

C Harvey ,
H Killaspy ,
S Martino ,
S White  and
S Johnson
C Harvey
Affiliation:
Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
H Killaspy
Affiliation:
University College London Camden and Islington Mental Health and Social Care Trust, UK
S Martino
Affiliation:
Private Psychiatrist, Glen Iris, Melbourne
S White
Affiliation:
St George's University, London, United Kingdom
S Johnson
Affiliation:
University College London Camden and Islington Mental Health and Social Care Trust, UK
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Abstract

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Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006 , pp. 254
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

Differences in implementation of assertive community treatment (ACT) could explain variability in reported effectiveness.

Methods:

The Pan London Assertive Outreach (PLAO) studies examined ACT implementation and effectiveness amongst 24 London teams (Wright et al. 2003; Billings et al. 2003; Priebe et al. 2003). The current study gathered data on team organization, staff and client characteristics from four Melbourne ACT teams using identical participant sampling and data collection methods to the PLAO studies (except client characteristics were collected from Melbourne team staff rather than case notes).

Results:

Melbourne teams were significantly different from London cluster C teams so comparisons were with cluster A and B teams only. All Melbourne teams worked extended hours; they took greater responsibility for dealing with crises than the London teams. Three of the four Melbourne teams achieved a majority (>70%) of client contacts in vivo compared with only one third of the London teams. There were no significant differences between Melbourne and London teams regarding staff satisfaction and burnout. Client sociodemographic characteristics were very similar. Three quarters of all clients in both countries were admitted in the preceding 2 years but half the bed days were used in Melbourne.

Conclusions:

An important difference in the implementation of ACT between Melbourne and London could be home visiting, a postulated ‘active component’ of models of home-based treatment. Melbourne teams may be more proactive in admitting patients at an earlier stage of relapse.