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Staff attitudes towards particular client difficulties in assertive outreach teams

Published online by Cambridge University Press:  13 June 2014

Rowena Jones ,
Dermot McGovern  and
Bethan Reading
Rowena Jones*
Affiliation:
West Midlands Poisons Unit, City Hospital, Birmingham B18 7QH, UK
Dermot McGovern
Affiliation:
Ladywood Assertive Outreach Team, Ladywood Middleway, Ladywood, Birmingham B1 2JT, UK
Bethan Reading
Affiliation:
Early Intervention Service, Harry Watton House, Church Lane, Aston, Birmingham B6 5UG, UK
*
*Correspondence Email: rowena.jones@btinternet.com
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Abstract

Objective: Over recent years in England there has been widespread development of assertive outreach teams supporting patients with severe mental illness living in the community. Assertive outreach staff members are exposed to a variety of new stressors and risks. This study investigated the emotional impact on keyworkers of working with assertive outreach patients. This was considered in terms of the attitudes keyworkers hold towards patients with particular types of difficulty. The study also measured individual keyworker stress.

Methods: Keyworkers from three teams in Birmingham were surveyed regarding their attitudes towards individual patients. Questionnaires measuring attitudes and patient difficulties were derived for the purpose of the study. Strengths of attitudes were correlated against different patient difficulties. Keyworker stress was measured using the General Health Questionnaire, GHQ12.

Results: Certain patient difficulties, in particular poor engagement, psychotic symptoms and aggression were associated with feelings of failure in keyworkers whilst drug use, particularly crack cocaine use, was associated with fear of visiting patients at home. Some 41% of keyworkers met ‘caseness’ criteria on the GHQ12. Negative attitudes appeared to be independent of GHQ scores.

Conclusions: Keyworkers expressed a number of positive and negative attitudes in relation to patient difficulties. Negative attitudes did not appear to be simply a feature of keyworker stress, however it is acknowledged that the sample size was small. Keyworkers' responses suggested a sense of personal failure when their patients were unwell or poorly engaged, despite patients being selected for assertive outreach on the basis of such difficulties. Recognition of negative attitudes may help in the improvement of training and supervision of staff members.

Keywords

AttitudesStressAssertive outreachKeyworkers.
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 25 , Issue 4 , December 2008 , pp. 131 - 136
Copyright
Copyright © Cambridge University Press 2008

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