Implementation of a recovery-oriented assertive community treatment (Re-ACT) program for people with heavy use of psychiatric treatment in Switzerland: results from a three-year pilot study

International guidelines recommend the provision of community based treatment as an alternative to predominant inpatient stays in psychiatric hospitals for people with severe mental illnesses. Assertive community treatments have been introduced across the globe; however, the development and implementation of such treatment options are still limited in Switzerland in general and were, until recently, not available in Basel-Stadt.

We here describe the development and implementation of an assertive community treatment program created specifically for people with previous heavy use of psychiatric inpatient services in the canton of Basel-Stadt. The program offers this patient group a need-centered and recovery-oriented treatment option following an inpatient stay. Primary objectives are a reduction in the likelihood of further inpatient stays and the potential experience of involuntary admissions as well as high participant satisfaction.

Results from the three-year pilot study (2019-2022) are reported here on a case-level. We compare objective outcome measures for people participating in the program after an inpatient stay and receiving minimal treatment (n_cases = 110) versus people not participating (n_cases = 292). Overall, we show that program participation is associated with a lower number of inpatient treatment days, inpatient stays and number of involuntary admissions. Feedback on subjective outcome measures indicates high treatment satisfaction.

These findings speak to the feasibility of the program's implementation and provide a first outlook for a new recovery-oriented treatment option for people with a history of frequent hospitalizations.