Hambleton and Richmondshire Assertive Outreach Team

Colburn GP Surgery

Easton Way

Colburn, DL9 4GA

Tel number: 01748 834581

About the service

The assertive outreach team is part of community mental health services and works with adults with severe mental illness who have difficulty engaging in services, have repeat admissions to hospital and may have other problems such as violence, self harm, homelessness and substance abuse.

The service offers other areas of support, including:

  • Help with daily living such as shopping, budgeting and domestic chores
  • Help in taking medication including reviews and help with side effects
  • Help with substance abuse including referral to a specialist service if needed
  • Help to increase social networks and reduce isolation
  • Help to improve physical health
  • Support in finding suitable education, employment and training opportunities
  • Help in finding and keeping suitable accommodation
  • Development of a relapse prevention plan which looks at triggers and symptoms, as well as action for individuals, their family and carers
  • Increased support to prevent hospital admission or arrange in-patient care, if necessary.

The assertive outreach team works at developing long term relationships with its clients to build up trust.

Care coordinators in the assertive outreach team have a smaller case load (fewer clients at one time) than the usual community mental health teams. This is so they can see their clients frequently and stay in contact.

The team will be persistent when trying to engage with individuals and make repeated attempts to see them, however difficult that may be. The team works with the person in their own environment, be that their home, a cafe, a park or in the street - wherever it is most needed and most effective.

The assertive outreach team

The team has staff with a mixture of skills to meet the complex needs of the people they support.

It is a relatively small team consisting of two community psychiatric nurses, an occupational therapist, a social worker and three support time recovery workers who work differing hours.

The team operates 9am to 5pm Monday to Friday.

There is also a team consultant psychiatrist and access to services which support employment and education.

How to access the service

To be eligible for assertive outreach services you normally have to be referred by the community mental health team, but referrals can also be made through a hospital team or the intensive home treatment team.

If you agree to being referred, the assertive outreach team will assess you and discuss your needs and aspirations, and the ways in which the team will be able to support you.

You will be allocated a care coordinator and will generally also receive support from a support time recovery worker, depending on your needs. You will also be offered regular reviews and care plan meetings.

People stay with the team for as long as they need and once an agreed level of independence and stability is reached, you will be referred back to your original team for continued support.