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The REACT study: randomised evaluation of assertive community treatment in north London
Helen Killaspy1, Paul Bebbington, Robert Blizard
1Department of Mental Health Sciences, University College London, London NW3 2PF. h.killaspy@medsch.ucl.ac.uk
BMJ (Clinical Research Ed.)
|March 18, 2006
Summary
Assertive community treatment (ACT) teams and community mental health teams (CMHTs) show similar effectiveness for serious mental illnesses. ACT may improve client engagement and satisfaction with mental health services.
Area of Science:
- Psychiatry
- Mental Health Services Research
- Clinical Trials
Background:
- Serious mental illnesses (SMI) require effective community-based care.
- Engagement and satisfaction are key outcomes in mental healthcare.
Purpose of the Study:
- To compare the effectiveness of assertive community treatment (ACT) teams versus community mental health teams (CMHTs) for individuals with SMI.
- To evaluate differences in inpatient bed use, symptoms, social function, client satisfaction, and service engagement.
Main Methods:
- A non-blind randomised controlled trial was conducted in two London boroughs.
- 251 participants with SMI and high recent inpatient use were randomized to ACT or CMHT care.
- Inpatient bed use at 18 months was the primary outcome.
Main Results:
- No significant differences were observed in inpatient bed use or overall clinical/social outcomes between ACT and CMHT groups.
- ACT demonstrated improved client engagement and higher client satisfaction compared to CMHTs.
- Specific measures showed statistically significant improvements in engagement and satisfaction for the ACT group.
Conclusions:
- CMHTs provide effective care for individuals with SMI, comparable to ACT teams.
- ACT may offer advantages in enhancing client engagement and satisfaction within mental health services.
- Further research could explore optimal models for integrating ACT principles into broader CMHT frameworks.