27 February 2023
Many readers of this handbook will have a sense of what is meant by assertive outreach. However, it is hard to create a single definition. Many existing definitions have their foundations in work with street homeless people or people with mental health problems, and in particular the American Assertive Community Treatment model for working with people with severe mental illnesses. However, the focus and style of outreach work will vary between settings and populations.
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Introduction
The gap between identification and treatment
Alcohol issues are rarely simple. They may arise from past trauma or current adversity. They may be linked to other physical and mental health issues, and to social and relationship difficulties. They may cause, co-occur with, or result from any of these other issues. All these complex needs demand appropriate support, but also create barriers to accessing that support, and it is not always reasonable to expect someone to show obvious motivation to change.
The experience of Alcohol Change UK’s Blue Light approach has shown that if people need support but don’t come into services, services may need to go out and find them through assertive outreach. That means making time to work with people in their own settings and build engagement with them through persistent and consistent interactions. This handbook is based on a recognition that identifying an alcohol problem does not always lead smoothly and naturally to treating it. In an ideal world, the path to treatment would look something like this:
The reality is more complex. Family members, for example, usually have no problem identifying an alcohol problem in a loved one. A doctor may refer that person for specialist help. They may still never access treatment. For many people needing treatment for alcohol issues, a more effective model of support would look something like this:
Alcohol assertive outreach is a method for moving positively, patiently and persistently with someone across the gap between identification and treatment, and beyond.
This handbook is about how you can implement it effectively in your local area.
