1. Newport Assertive Outreach Team Not Just A Taxi Service

2. AGENDA  Introductions and Aims  Songs  Model of Service  How Do We Make Decisions-Risks, Rights and Responsibilities  Team Approach and Statistics

3. SONGS

4. MODEL OF SERVICE Engagement Developing a partnership Active Treatment Relapse Prevention

5. Engagement Shaping an effective working alliance Psycho-social Interventions Medication and symptom management

6. ENGAGEMENT Shaping an effective working alliance  Conduct outreach to establish regular contact  Being useful-provide practical help and support  Establish open, honest communication through active listening, getting to know the person behind the illness.

7. ENGAGEMENT Psychosocial interventions  Gaining knowledge of family  Starting to assess Activities of Daily Living  Awareness of physical health  Awareness/assessment of substance misuse  ‘Accepting’ conversations regarding perceptions of mental health

8. ENGAGEMENT Medication/Symptom Management  Medication delivery  Ensure medication available  Monitoring medication compliance

9. ENGAGEMENT Medication/Symptom Management  Starting to assess side effects  Symptom acknowledgement and monitoring  Weekly medication supervision and review if necessary

10. DEVELOPING A PARTNERSHIP Psychosocial interventions  Continue regular contact start to negotiate continued contact  Building a trusting relationship through reliability and advocacy  Working more in collaboration towards resolution of practical tasks

11. DEVELOPING A PARTNERSHIP Psychosocial interventions  Information re: illness/medication if wanted  Introduction to stress/vulnerability model through informal conversation  Informal coping strategies  Establishing relationships with family/carers as appropriate to include carers assessment, if appropriate

12. DEVELOPING A PARTNERSHIP Psychosocial interventions  Identifying interests, strengths, skills and aspirations  Monitor any physical health changes.  Consider Motivational Interviewing intervention at contemplation stage re substance misuse if appropriate

13. DEVELOPING A PARTNERSHIP Medication/Symptom Management  Assessment of side effects  Assessment of symptoms  Reality checking  Ongoing monitoring and management of medication compliance

14. ACTIVE TREATMENT Shaping an effective working alliance  Regular agreed contact  Supporting progress and concordance with the plan

15. ACTIVE TREATMENT Psychosocial interventions  Reinforce coping strategies  Consider Occupational Therapy assessment  Consider ‘family work’ if appropriate  Physical health education and support

16. ACTIVE TREATMENT Psychosocial interventions  Goal setting – strengths based/solution focused interventions-future plans- timetable for activities  Help service user to repair burnt bridges to re-establish relationships  Enlist family support for sustained lifestyle changes  Engage in MI re: Substance Misuse if appropriate

17. ACTIVE TREATMENT Medication/Symptom Management  On-going support  Development of relapse indicators with service users, steps to be taken and advance directives

18. RELAPSE PREVENTION Shaping an effective working alliance  Maintain/consider reduction in contact  Promote development of their supportive relationships  Boost self efficiency/positive reinforcement and consider other areas of development – move towards independence

19. RELAPSE PREVENTION Psychosocial interventions  Develop a formal relapse prevention plan  Continue with Psychoeduction  Provide information related to health, well being and lifestyle change  Help service users learn how to obtain information themselves  Explore a service user becoming a peer educator for others

20. RELAPSE PREVENTION Medication/Symptom Management  Promote independence with medication compliance  Psychoeduction on long term use and effects of medication  Continued symptom monitoring.

21. DECISION MAKING What interventions and when  Risks  Rights  Responsibilities

22. SENARIO  What risks do we need to consider  What and whose rights should be influencing our decision making?  Who holds responsibility and for what?

23. HUMAN RIGHTS AGENDA  Fairness  Respect  Equality  Dignity  Autonomy

24. HOW DO WE DELIVER OUR SERVICE  Daily handover  Weekly team meeting-psychiatrist  3 monthly review of risk management plan at team meeting  3 monthly CPA  6 month review of relapse indicators

25. HOW DO WE DELIVER OUR SERVICE  All staff see all service users  Different voices but the same song

26. HAS IT WORKED? Service user- Evaluations  Understand my problems  They lift my spirit when I see them  They are fascinated by my beliefs  They treat me with respect  I don’t feel isolated  I need to be in my community, the AOT helps with speaking to the benefit agency  I haven’t got any bad things to say except I’d like to get off the depot- they are doing their best.

27. ENGAGEMENT

28. LIFE SKILLS PROFILE

29. MEDICATION COMPLIANCE

30. BED DAYS