title: Randomized controlled trial of assertive community treatment in intellectual disability: the TACTILD study.
abstract: BACKGROUND
  There has been a policy shift away from hospital to community in the services of all those with psychiatric disorders, including those with intellectual disability (ID), in the last 50 years. This has been accompanied recently by the growth of assertive outreach services, but these have not been evaluated in ID services.
  
  
  METHODS
  In a randomized controlled trial we compared assertive outreach with 'standard' community care, using global assessment of function (GAF) as the primary outcome measure, and burden and quality of life as secondary measures.
  
  
  RESULTS
  We recruited 30 patients, considerably less than expected; no significant differences were found between the primary and secondary outcomes in the two groups. The differences were so small that a Type II error was unlikely.
  
  
  CONCLUSIONS
  Reasons for this lack of specific efficacy of the assertive approach are discussed and it is suggested that there is a blurring of the differences between standard and assertive approaches in practice.
authors.affiliation: Department of Psychological Medicine, Faculty of Medicine, Imperial College London, Paterson Centre, London, UK. p.oliver@imperial.ac.uk
authors.forename: P C
authors.initials: PC
authors.lastname: Oliver
authors.forename: J
authors.initials: J
authors.lastname: Piachaud
authors.forename: P
authors.initials: P
authors.lastname: Tyrer
authors.forename: A
authors.initials: A
authors.lastname: Regan
authors.forename: M
authors.initials: M
authors.lastname: Dack
authors.forename: R
authors.initials: R
authors.lastname: Alexander
authors.forename: A
authors.initials: A
authors.lastname: Bakala
authors.forename: S
authors.initials: S
authors.lastname: Cooray
authors.forename: D J
authors.initials: DJ
authors.lastname: Done
authors.forename: B
authors.initials: B
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003156:Community Mental Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution*; D017281:Cost of Illness; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000628:therapy*; D007360:Intelligence; D008875:Middle Aged; D011795:Surveys and Questionnaires