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International Journal of Social Psychiatry
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Perceptions of Assertive Community Treatment in the UK and Lithuania

Peter Tyrer

Department of Psychological Medicine, Imperial College (Charing Cross Campus), London, UK, p.tyrer{at}imperial.ac.uk

Agne Balod

Vasaros Hospital, Vilnius, Lithuania

Arunas Germanavicius

Department of Social Psychiatry, University of Vilnius, Lithuania

Andrew McDonald

Community Outreach Rehabilitation Team, Woodfield Road, London, UK

Mythili Varadan

IMPACT Assertive Outreach Team, Barb Mews, London

Jacqui Thomas

IMPACT Assertive Outreach Team, Barb Mews, London

Background: There is current uncertainty over the future of assertive community and outreach teams in view of recent evidence suggesting that they no longer reduce hospital admissions. Despite this, assertive teams remain popular among practitioners.

Aims: To eXamine the views of assertive community team members and other mental health professionals in London (UK) and Vilnius (Lithuania) to determine important differences in attitudes.

Method: A questionnaire, involving the assessment of statements giving common opinions on assertive community teams, was given to 62 staff in Vilnius, Lithuania and West London, UK, 33 from assertive community or outreach teams and 29 from other mental health professionals.

Results: The results of the questionnaire showed that personnel in eXperienced assertive outreach teams in London believed that they gave more intensive care (p < 0.001), felt it of greater value to see patients in the community (p < 0.001) and were not just well-resourced community teams with low caseloads (p < 0.01) than did other groups, but they placed lower value on assertiveness (p = 0.04) and comprehensive care (p < 0.04). These differences were less marked in Lithuania where staff regarded home treatment as similar to clinic treatment and were more supportive of comprehensive care.

Conclusion: The results suggest that in eXperienced community teams the notion of assertiveness has become less important in planned intensive community care and so the term ACT may be outmoded. However, for countries such as Lithuania, somewhat similar to the United States in 1972 when ACT began, the original principles are still appropriate and `assertive' is a major component of their effectiveness.

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  • Peter Tyrer, Department of Psychological Medicine, Imperial College (Charing Cross Campus), London, UK. Agne Balod, Vasaros Hospital, Vilnius, Lithuania.
  • Arunas Germanavicius, Department of Social Psychiatry, University of Vilnius, Lithuania.
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  • Jacqui Thomas, IMPACT Assertive Outreach Team, Barb Mews, London.

International Journal of Social Psychiatry, Vol. 53, No. 6, 498-506 (2007)
DOI: 10.1177/0020764007083868
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