Perceptions of assertive community treatment in the UK and Lithuania.
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.


OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
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.
Tyrer
Peter
P
Department of Psychological Medicine, Imperial College, Charing Cross Campus, London, UK. p.tyrer@imperial.ac.uk
Balod
Agne
A
Germanavicius
Arunas
A
McDonald
Andrew
A
Varadan
Mythili
M
Thomas
Jacqui
J
D001291:Attitude of Health Personnel; D003156:Community Mental Health Services; D003159:Community-Institutional Relations; D006699:Home Care Services; D006801:Humans; D008131:London; D001523:Mental Disorders / Q000628:therapy*; D010348:Patient Care Team; D012938:Social Perception; D011795:Surveys and Questionnaires; D013808:Therapeutic Community; D006113:United Kingdom