Staff attitudes towards particular client difficulties in assertive outreach teams

Area of Science:

• Mental Health Services Research
• Community Psychiatry
• Occupational Psychology

Background:

• Assertive outreach teams in England support community-dwelling severe mental illness patients.
• Staff in these teams face unique stressors and risks.
• Understanding the emotional impact on keyworkers is crucial for service improvement.

Purpose of the Study:

• To investigate the emotional impact on keyworkers in assertive outreach teams.
• To examine the relationship between keyworker attitudes and patient difficulties.
• To measure individual keyworker stress levels.

Main Methods:

• Survey of keyworkers from three Birmingham-based assertive outreach teams.
• Utilized custom questionnaires for attitudes and patient difficulties.
• Correlated attitude strengths with patient difficulties; measured stress using the General Health Questionnaire (GHQ12).

Main Results:

• Poor patient engagement, psychotic symptoms, and aggression correlated with keyworker feelings of failure.
• Drug use, especially crack cocaine, was linked to fear of home visits.
• 41% of keyworkers met 'caseness' criteria on the GHQ12; negative attitudes were independent of stress scores.

Conclusions:

• Keyworkers exhibited varied attitudes towards patient difficulties, with negative attitudes not solely explained by stress.
• A sense of personal failure was reported when patients were unwell or disengaged.
• Findings suggest a need for improved staff training and supervision, acknowledging the small sample size.