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Effectiveness of assertive community management in Singapore
Lambert Low1, Yu Yuan Tan, Boon Leng Lim
1Community Psychiatry Department, Institute of Mental Health, 10 Buangkok View, Singapore 539747. lambert.low@mohh.com.sg
Annals of the Academy of Medicine, Singapore
|April 23, 2013
Summary
Assertive Community Management (ACM) in Singapore significantly reduced hospital admissions and length of stay for chronically mentally ill patients. This community-based program demonstrates ongoing effectiveness in psychiatric care.
Area of Science:
- Psychiatry
- Public Health
- Health Services Research
Background:
- Assertive Community Treatment (ACT) pioneered community-based case management for severe mental illness.
- Assertive Community Management (ACM) in Singapore, launched in 2003, adapted ACT for de-institutionalization.
- ACM provides a mobile, multidisciplinary team approach for managing chronic psychiatric conditions.
Purpose of the Study:
- To evaluate the effectiveness of the Assertive Community Management (ACM) program in Singapore.
- To provide an updated analysis of ACM's impact on patient outcomes since its inception.
- To assess the predictive value of socio-demographic factors on ACM outcomes.
Main Methods:
- A naturalistic, retrospective study design was employed.
- Included 155 patients who completed one year in the ACM program (Sept 2008-2009).
- Compared Number of Admissions (NOA) and Length of Stay (LOS) one year pre- and post-ACM induction.
Main Results:
- Mean NOA decreased from 1.9 to 0.6 (P <0.01), a reduction of 1.3 admissions.
- Mean LOS decreased from 72.2 to 17.1 days (P <0.01), a reduction of 55.1 days.
- Gender, diagnoses, and ethnicity did not predict NOA or LOS outcomes.
Conclusions:
- Assertive Community Management (ACM) is well-established in Singapore.
- ACM effectively reduces inpatient hospitalizations for individuals with chronic mental illness.
- The program demonstrates sustained positive outcomes in community psychiatric care.
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