A randomised controlled trial of assertive outreach vs. treatment as usual for black people with severe mental illness.

AIM:

We aimed at testing whether an assertive outreach team (AOT) run by a Black voluntary organisation is more acceptable to Black people with severe mental illness.

METHODS:

A randomised controlled trial (RCT) of 83 Black (African, African Caribbean or Black British) patients with severe mental illness with treatment as usual (TAU) or Assertive Outreach (AO) by a non-statutory sector Black AOT. Frequency of admissions, duration of admissions, symptom severity and client satisfaction with clinical interventions were assessed.

RESULTS:

The mean length of admission at follow-up was not significantly different between the two groups (74.64 v. 64.51; mean difference= 10.13, 95% CI -2.86, 23.11, p= 0.125), neither was the mean number of admissions (1.32 v. 1.20; mean difference=0.13, 95% CI -0.18, 0.43, p = 0.401). Mean Brief Psychiatric Rating Scale (BPRS) ratings at 1-year follow-up were significantly lower in the AOT group than in the TAU group (56.34 v. 63.62; mean difference = 7.27, 95% CI 0.66, 13.88, p = 0.032), and people were significantly more satisfied with AOT 24/29 (83%) than the generic services: 4/26 (15%), p<0.001.

CONCLUSIONS:

While the AO service was highly culturally acceptable to Black people, there was no evidence that the provision of AOT reduces frequency or duration of hospital admission.