Assertive community treatment in the South African context

Area of Science:

• Psychiatry
• Public Health
• Community Mental Health Services

Background:

• Integration of psychiatric services into the community presents challenges in South Africa.
• A reduction in inpatient beds without adequate community resources has led to increased "revolving door" admissions.
• Poor socio-economic circumstances exacerbate these issues.

Purpose of the Study:

• To provide an overview of the experiences of the Stikland Psychiatric Hospital community treatment team.
• To assess the initial impact of an assertive outreach service in the South African context.

Main Methods:

• Establishment of three community treatment teams by APH in the Western Cape in January 2007.
• Overview of the first 12 months of operation for the Stikland Psychiatric Hospital team.
• Implementation of an "assertive" outreach service model.

Main Results:

• Several challenges were encountered in implementing the assertive outreach service.
• Early findings indicate a reduction in patient admissions.
• A decrease in the number of inpatient days was observed.

Conclusions:

• The initiative shows promise despite implementation challenges.
• Positive responses were received from service users, families, and staff.
• The assertive outreach model appears to be a necessary step in improving community psychiatric care in South Africa.