Improving physical health monitoring for out-patients on antipsychotic medication

intensively staffed facilities in the community. There was a sustained reduction in admissions but the gains appeared to plateau after the initial 2 years raising questions about the ongoing value of assertive outreach teams. As originally conceived, the teams’ intervention was intended to be indefinite and the argument made that gains would be lost once the service was withdrawn. However, this position has become increasingly contentious. Indeed, the philosophy of ‘no discharge’ may be to the detriment of both individuals and services. In this study only one person left and then returned to an assertive outreach team, whereas admission rates were lowest for people transferred to other teams. Although indicating that people can do well on moving to less intensive services, this may have been anticipated given the people’s perceived suitability for transfer. However, it is possible, given the plateau effect seen here after the first 2 years, that turnover of people on assertive outreach case-loads is too low (less than 5% per year here) and suggests that teams need to give more emphasis to exit strategies and set targets for moving on. About the authors