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Assertive community treatment: an update of randomized trials
1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Psychiatric Services (Washington, D.C.)
|July 1, 1995
Summary
Assertive community treatment significantly reduces hospital days and improves patient satisfaction for seriously mentally ill individuals. Further research is needed to explore its role as a continuous service and its impact on functional outcomes like employment.
Area of Science:
- Psychiatry
- Mental Health Services Research
- Evidence-Based Practice
Background:
- Assertive Community Treatment (ACT) is an evidence-based practice for severe mental illness.
- Previous research has shown mixed results regarding ACT's effectiveness.
Purpose of the Study:
- To synthesize the findings of randomized clinical trials (RCTs) on ACT published between 1990 and 1994.
- To identify gaps and future research directions for ACT.
Main Methods:
- Systematic review of RCTs evaluating ACT interventions published from 1990 onwards.
- Literature searches using MEDLINE and PsychLit, supplemented by investigator contact.
Main Results:
- ACT demonstrated significant positive effects on reducing hospital days and enhancing patient and family satisfaction.
- Methodological improvements in recent trials include larger sample sizes and longer durations.
- Functional outcomes like employment may necessitate targeted interventions beyond standard ACT.
Conclusions:
- Further research is required to define ACT's optimal role (e.g., time-limited, adjunct, or comprehensive service).
- The expanding evidence base will inform policy decisions regarding ACT's costs, outcomes, and indications for adults with severe mental illness.