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Assertive community treatment in the Netherlands: a randomized controlled trial.

S Sytema¹, L Wunderink, W Bloemers

¹Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. s.sytema@med.umcg.nl

Acta Psychiatrica Scandinavica

|July 26, 2007

Summary

Assertive community treatment effectively maintains patient contact, aligning with UK findings but not reducing hospital admissions. This approach is vital for engaging individuals lost in standard mental healthcare systems.

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Area of Science:

Mental Health Services Research
Psychiatric Epidemiology
Community Psychiatry

Background:

Assertive community treatment (ACT) is widely adopted in European mental health services.
Recent studies, particularly in the UK, have questioned the efficacy of ACT, contrasting with earlier US trial results.
There is a need to determine if UK findings are generalizable to other European mental health systems.

Purpose of the Study:

To evaluate the effectiveness of ACT compared to standard community mental health care.
To assess ACT's impact on patient contact, housing stability, and hospital admission rates.
To ascertain if ACT's effectiveness varies across different European mental health service contexts.

Main Methods:

An open randomized controlled trial involving long-term severely mentally ill patients (HoNOS score ≥15).
Participants were assigned to either ACT (n=59) or standard community care (n=59).
Outcomes measured included sustained contact, housing stability, and hospital admission days.

Main Results:

ACT demonstrated significantly better sustained patient contact compared to standard care.
No significant differences were observed in housing stability, psychopathology, social functioning, or quality of life.
ACT did not significantly reduce hospital admission days.

Conclusions:

The study's findings align with UK-based research on ACT.
The capacity of ACT to maintain sustained patient contact is a critical finding, addressing a common issue in standard care.
ACT's effectiveness in improving sustained contact highlights its value for engaging hard-to-reach patient populations.