Assertive outreach brings better lives to people with severe mental illnesses, says new book

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Some people who experience the most severe mental illnesses have a better chance of an ordinary life if they have the support of a high quality assertive outreach team, according to a book published today by The King's Fund and the Sainsbury Centre for Mental Health.

Out of the Maze, by Angela Greatley and Richard Ford, shows that assertive outreach teams work best when they help people who have serious problems but who do not want to use mental health services. The teams help them to cope with the challenges of everyday life, such as getting a job, finding somewhere to live and having a social life. This can make the difference between living in the community and being forced to go into a psychiatric hospital.

Out of the Maze is the result of Working Together in London: a major three-year, Department of Health-supported initiative by The King's Fund and the Sainsbury Centre in three areas of the capital.

In each, a dedicated assertive outreach team was set up to work with severely ill patients who have previously not kept in touch with mental health services or who have been in hospital. Typically a team includes a psychiatrist, a social worker, mental health nurses and a range of other professionals. By working as a team, they can not only provide treatments for mental illness, they also help people to get their lives back and become equal members of their communities.

Sainsbury Centre chief executive Matt Muijen said:

'People with severe mental illnesses are often isolated from their communities. Most do not have a job, and many lack the friendships that most of us consider a fundamental part of normal life. Those from black and minority ethnic groups often experience double discrimination. Assertive outreach teams can help to combat this exclusion and enable people to rebuild their lives.'

The King's Fund mental health fellow Angela Greatley said:

'Assertive outreach is an effective way of helping people with mental illnesses get their lives back. Yet just as it is getting started it is also under threat. The Government's draft Mental Health Bill could turn back the clock, putting more people in hospital and forcing assertive outreach teams to be the instruments of compulsory community treatment. A wonderful opportunity to build better community-based mental health care for some of those with the most serious problems would then be lost.'

Read the report: Out of the Maze: Reaching and supporting Londoners with severe mental health problems

Notes to editors

The three pilot projects involved in the Working Together in London scheme were:

  • The Antenna Outreach Service, based in Tottenham and Edmonton;
  • Lambeth Early Onset (LEO);
  • The Islington Assertive Outreach Team, based in south Islington.

Out of the Maze, by Angela Greatley and Richard Ford, is available from the King's Fund bookshop on 020 7307 2591, and the Sainsbury Centre for Mental Health on 020 7827 8300 or, price £10.

The King's Fund and the Sainsbury Centre for Mental Health are also today publishing Independent and Able to Cope: Evaluation of Working Together in London - an integrated mental health initiative, by John Lee, Paul McCrone and Richard Ford, available free from both organisations.

For review copies of either publication, or interviews with the authors, please contact Daniel Reynolds on 020 7307 2581 or 07831 554927.