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A randomised controlled trial of assertive outreach vs. treatment as usual for black people with severe mental illness

Published online by Cambridge University Press:  28 March 2011

D. Bhugra ,
O. Ayonrinde ,
G. Butler ,
M. Leese  and
G. Thornicroft
D. Bhugra*
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
O. Ayonrinde
Affiliation:
South London and Maudsley NHS Foundation Trust, London, UK
G. Butler
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
M. Leese
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
G. Thornicroft
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
*
*Address for correspondence: Professor Dinesh Bhugra, Health Service & Population Research Department, Institute of Psychiatry, King's College London, PO Box 25, De Crespigny Park, London SE5 8AF, UK. (Email: dinesh.bhugra@.kcl.ac.uk)
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Abstract

Aim.

We aimed at testing whether an assertive outreach team (AOT) run by a Black voluntary organisation is more acceptable to Black people with severe mental illness.

Methods.

A randomised controlled trial (RCT) of 83 Black (African, African Caribbean or Black British) patients with severe mental illness with treatment as usual (TAU) or Assertive Outreach (AO) by a non-statutory sector Black AOT. Frequency of admissions, duration of admissions, symptom severity and client satisfaction with clinical interventions were assessed.

Results.

The mean length of admission at follow-up was not significantly different between the two groups (74.64 v. 64.51; mean difference = 10.13, 95% CI −2.86, 23.11, p = 0.125), neither was the mean number of admissions (1.32 v. 1.20; mean difference = 0.13, 95% CI −0.18, 0.43, p = 0.401). Mean Brief Psychiatric Rating Scale (BPRS) ratings at 1-year follow-up were significantly lower in the AOT group than in the TAU group (56.34 v. 63.62; mean difference = 7.27, 95% CI 0.66, 13.88, p = 0.032), and people were significantly more satisfied with AOT 24/29 (83%) than the generic services: 4/26 (15%), p < 0.001.

Conclusions.

While the AO service was highly culturally acceptable to Black people, there was no evidence that the provision of AOT reduces frequency or duration of hospital admission.

Keywords

Assertive outreachblack patientsrandomised controlled trial (RCT)
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 20 , Issue 1 , March 2011 , pp. 83 - 89
Copyright
Copyright © Cambridge University Press 2011

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