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Assessing the efficacy of a modified assertive community-based treatment programme in a developing country
Ulla A Botha1, Liezl Koen, John A Joska
1Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa. ulla@sun.ac.za
BMC Psychiatry
|September 17, 2010
Summary
This study shows modified assertive treatment services significantly improve outcomes for severe mental illness patients in developing countries. The intervention reduced psychiatric admissions and improved functioning, demonstrating effectiveness in under-resourced settings.
Area of Science:
- Psychiatry and Mental Health
- Global Health
- Health Services Research
Background:
- Assertive interventions have shown mixed results in developed countries.
- Standard care may have evolved, incorporating elements of assertive models.
- This study is the first randomized controlled trial of assertive treatment in a developing country.
Purpose of the Study:
- To assess the effect of a modified assertive treatment service on readmission rates and other outcomes in a developing country.
- To evaluate the efficacy of a tailored assertive intervention for severe mental illness.
Main Methods:
- Randomized controlled trial with high-frequency service users.
- Intervention group received modified assertive community treatment; control group received standard care.
- Data collected at baseline and 12 months, including symptomology, functioning, and readmission rates.
Main Results:
- The assertive intervention group showed significantly lower PANSS scores (total, positive, general psychopathology).
- Improved functioning (higher SOFAS scores) was observed in the intervention group.
- Significantly fewer psychiatric admissions occurred in the intervention group.
Conclusions:
- Modified assertive interventions are effective in developing settings with under-resourced mental health services.
- These interventions can reduce inpatient days and improve patient outcomes.
- Cost-effective, adapted assertive models can be successfully implemented globally.
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