Key features of ACT are: assertive engagement, a small caseload (maximum of 10 patients per clinician); shared caseload (i.e. all clinicians collaborated closely on each patient using one treatment plan); and community-based and assertive services on a time-unlimited basis [ 5, 19].
The purpose of this study was to determine the impact of a tailored, assertive treatment service on readmission rates and other measures of outcome in HFUs of psychiatric services in a developing country This study was conducted at Stikland Hospital, one of the three large state psychiatric hospitals in Cape Town, South Africa.
Our study represents the first randomised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country.
We know there is a need for more "assertive" community services, to reach out to people who do not benefit from the current system where they are rather than waiting for them -- or forcing them -- to come to the mental health system on their own.
The frequency of assertive consultations and service use suggest that patients accepted the experimental intervention by adhering to the approach.
Much more assertive promotion of services – through GPs, carers' organisations, the internet and local information portals, for example – is needed if services are to become accessible to all who can benefit from them.
Howard Sinclair, chairman of Broadway London, a homeless charity, hears rumours of a rise in homelessness in smaller towns as London becomes more assertive about refusing services to those without a local connection.
An expanding, global middle class is newly assertive about better services and access to opportunity; farmers in developing economies insist there can be no more opening up of markets until western crops stop being subsidised.
According to parents, even when services were available, professionals often associated the child's behaviour with a normal developmental phase and only through being assertive did parents receive service support.
Tendayi Darikwa's right wing cross was pitched perfectly, and serviced an assertive leap between Chambers and Gabriel.
