Outreach in Community Mental Health Care A Manual for Practitioners

Outreach in the community is the treatment of choice for the severely mentally ill in the community. It involves taking services directly to patients rather than requiring them to attend clinics and hospitals. This approach is a significant addition to routine mental health care practice and addresses the needs of marginalized communities and those that struggle to attend appointments.

Outreach in Community Mental Health Care: A Manual for Practitioners has been fully updated since the last edition, providing readers with an in-depth, practical guide to mental health care in the community setting today. It addresses the significant changes in mental health service organizations over the years, including the various new teams devised and the importance of central planning and targets.

The authors Tom Burns and Mike Firn are pioneers in this field of research and are active in community outreach as practitioners, researchers, and supervisors. In 29 chapters they cover key discussions in conceptual issues, health and social care practice, management and development, which provides readers with an insight into the reality of community outreach work.

Tom Burns, Professor Emeritus of Social Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK,Mike Firn, Nurse and Healthcare Consultant, South West London & St George's Mental Health NHS Trust and Springfield Consultancy, Springfield Hospital, London, UK

Tom Burns is Professor Emeritus of Social Psychiatry at the University of Oxford. Before that he was consultant psychiatrist and professor of Community Psychiatry at St George's in South West London where he and Mike Firn together set up and ran the Wandsworth Assertive Community Treatment Team. He has predominantly researched community mental health services practice, particularly complex interventions. He has published six books with Oxford University Press. Our Necessary Shadow: The Nature and Meaning of Psychiatry, a book on psychiatry for the general reader was published by Penguin in 2014. He was awarded the CBE in 2006 for services to mental health care.



Mike Firn has over 30 years' experience in the National Health Service in England as a registered nurse, team leader and operational manager. He has set up, developed and evaluated numerous new community mental health teams across the care pathway from early intervention, assertive outreach and crisis services. He is a current board member of national and European clinical networks in assertive outreach. He also provides much of his time as an external consultant for an independent charity, The Health Foundation, working alongside grant funded health innovation projects.

Conceptual issues
1. The evolution of community outreach
2. Current context and aims
3. Who is assertive outreach for? Referrals and discharges
4. Model variance and model fidelity: the lessons from ACT
5. Key working versus the 'whole-team approach'
6. Access: office hours, shifts or 24/7 availability?
7. The role of medication
8. Compulsion and freedom
9. Cultural sensitivity
Health and social care practice
10. Engagement
11. Medication compliance
12. Hostility
13. Suicidality
14. Self-neglect
15. Schizophrenia and delusional disorders
16. Bipolar affective disorder
17. Personality problems and disorders
18. Depression, anxiety, and situational disorders
19. Substance misuse/dual diagnosis
20. Finance and appointeeship
21. Housing and homelessness
22. Physical health care
23. Employment
24. Daily living skills
25. Psychosocial interventions with families, carers and patients
Management and Development
26. Operational and team management
27. Training
28. Service planning
29. Research and development