An unholy alliance: substance abuse and social exclusion among assertive outreach patients

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Abstract
Objective:  To investigate the relationship between social exclusion and outcomes of mentally ill patients with substance abuse problems receiving assertive outreach treatment in London.Method:  Analysis was conducted on data on 580 patients from the ‘Pan‐London Assertive Outreach Study (PLAO)’. Data were collected using clinician‐rated scales of alcohol and drug abuse in the last 6 months before baseline. Outcomes – hospitalization and compulsory hospitalization– were assessed over a 9‐month follow‐up period.Results:  The analysis identified a group of patients with substance abuse who suffer from social exclusion and forensic problems (n = 77, 15.8%), and had poorer outcomes than the rest of the patients in terms of hospitalization (52% vs. 36% respectively) and compulsory (39% vs. 22% respectively) hospitalization.Conclusion:  There is a distinct group of patients whose treatment requires social inclusion and forensic expertise. Future research into which model of service is suitable for these patients and in what setting is recommended.

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