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Examining Youth Flexible ACT Model Implementation in the Netherlands.

Marieke Broersen1,2, Nynke Frieswijk3, Maaike van Vugt4

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Youth Flexible Assertive Community Treatment (ACT) teams in the Netherlands show high model adherence. Improvements are needed in specialized disciplines and specific interventions for optimal mental health care quality.

Keywords:
Adolescent Mental HealthFlexible Assertive Community TreatmentIntegrated Care ApproachModel fidelity

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Area of Science:

  • Mental Health Services Research
  • Child and Adolescent Psychiatry
  • Healthcare Quality Improvement

Background:

  • Model adherence is crucial for quality mental health care.
  • Youth Flexible Assertive Community Treatment (ACT) models are emerging in the Netherlands.
  • Assessing the implementation of these new models is essential.

Purpose of the Study:

  • To evaluate model adherence and care content in the first Dutch Youth Flexible ACT teams.
  • To identify areas of successful implementation and opportunities for improvement.
  • To assess the translation of the Flexible ACT framework into clinical practice.

Main Methods:

  • Sixteen Youth Flexible ACT teams were assessed using the Youth Flexible ACT model fidelity scale (2014).
  • Mental health workers completed a questionnaire on the content of care and interventions.
  • Data analysis focused on model fidelity scores and intervention mapping.

Main Results:

  • Twelve teams demonstrated 'optimal implementation' and four showed 'adequate implementation' of the Youth Flexible ACT model.
  • Most disciplines were integrated, but specific roles (peer support, employment specialist) and interventions (family, dual disorder) were underrepresented.
  • Frequency of contact and use of Routine Outcome Monitoring were below optimal levels.
  • Nearly half of clients received intensified ACT care, with most receiving individual psychological interventions.

Conclusions:

  • The implementation of Youth Flexible ACT in the Netherlands is largely successful, translating the theoretical model into practice.
  • Enhancements are recommended in integrating specialized disciplines, particularly peer support and employment specialists.
  • Further development of specific, protocolled interventions is needed to optimize care delivery.