An unholy alliance: substance abuse and social exclusion among assertive outreach patients.
OBJECTIVE
To investigate the relationship between social exclusion and outcomes of mentally ill patients with substance abuse problems receiving assertive outreach treatment in London.


METHODS
Analysis was conducted on data on 580 patients from the 'Pan-London Assertive Outreach Study (PLAO)'. Data were collected using clinician-rated scales of alcohol and drug abuse in the last 6 months before baseline. Outcomes - hospitalization and compulsory hospitalization- were assessed over a 9-month follow-up period.


RESULTS
The analysis identified a group of patients with substance abuse who suffer from social exclusion and forensic problems (n = 77, 15.8%), and had poorer outcomes than the rest of the patients in terms of hospitalization (52% vs. 36% respectively) and compulsory (39% vs. 22% respectively) hospitalization.


CONCLUSIONS
There is a distinct group of patients whose treatment requires social inclusion and forensic expertise. Future research into which model of service is suitable for these patients and in what setting is recommended.
Fakhoury
W K H
WK
Unit for Social and Community Psychiatry, Barts and The London School of Medicine, Queen Mary, University of London, London, UK. w.fakhoury@qmul.ac.uk
Priebe
S
S
D000328:Adult; D002391:Catchment Area, Health; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D003159:Community-Institutional Relations; D003710:Demography; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires