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Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder

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How many assertive community treatment teams do we need?

Gary S Cuddeback¹, Joseph P Morrissey, Piper S Meyer

¹Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, CB#7590, 725 Martin Luther King Jr. Boulevard, Chapel Hill, NC 27599-7590, USA. cuddeback@mail.schsr.unc.edu

Psychiatric Services (Washington, D.C.)

|December 13, 2006

Summary

Assertive Community Treatment (ACT) can reduce hospitalizations for individuals with severe mental illness. Communities should plan ACT services for about 50% of this population, or 0.06% of all adults.

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Area of Science:

Psychiatry
Health Services Research
Public Health Policy

Background:

Assertive Community Treatment (ACT) is effective in reducing hospitalizations for individuals with severe mental illness.
Current planning for ACT services lacks empirical guidelines, leading to potential under- or overestimation of needed resources.
Accurate estimation of ACT team needs is crucial for program capacity and meeting patient demand.

Purpose of the Study:

To develop empirical estimates for the number of Assertive Community Treatment (ACT) teams required in a community.
To evaluate existing conceptual guidelines for determining the number of ACT teams based on empirical data.

Main Methods:

Utilized administrative data from a large, urban county.
Identified individuals with severe mental illness who experienced three or more hospitalizations within a one-year period to determine ACT eligibility.

Main Results:

Approximately 51% of individuals with severe mental illness met the criteria for ACT eligibility (743 out of 1,453 persons).
This eligible population represented 2.2% of the county's total mental health service users.
The ACT-eligible group constituted 0.06% of the county's overall adult population.

Conclusions:

Communities should aim to establish sufficient ACT teams to serve approximately 50% of their severe mental illness population.
This translates to a need for ACT services for roughly 0.06% of the general adult population.
Empirical data supports a more precise approach to ACT service planning and resource allocation.