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A multisite study of client outcomes in assertive community treatment
J H McGrew1, G R Bond, L Dietzen
1Indiana University-Purdue University at Indianapolis, USA.
Psychiatric Services (Washington, D.C.)
|July 1, 1995
Summary
Assertive community treatment (ACT) programs significantly reduced psychiatric rehospitalization by one-third and inpatient days by 50% over 18 months. These findings support ACT as effective community care for serious mental illness.
Area of Science:
- Psychiatry
- Community Mental Health
- Health Services Research
Background:
- Assertive community treatment (ACT) is a critical intervention for individuals with serious mental illness.
- Effective community-based care is essential to reduce rehospitalization rates and improve patient outcomes.
Purpose of the Study:
- To evaluate the outcomes of clients admitted to ACT programs.
- To assess the impact of ACT on rehospitalization, quality of life, and functioning.
Main Methods:
- A longitudinal study of 212 clients admitted to six ACT programs over 18 months.
- Data collected at baseline and six-month intervals included rehospitalization rates, quality of life, and functioning levels.
- Statistical analyses included t tests and linear trend analysis to examine progressive improvements.
Main Results:
- Psychiatric hospitalizations decreased by 33%, and inpatient days reduced by 50%.
- Progressive improvements in quality of life and functioning were observed over the 18-month study period.
- Case managers reported enhanced social support, independence, and daily living skills, though clients reported more legal issues.
Conclusions:
- ACT programs demonstrate significant effectiveness in reducing rehospitalization and improving patient well-being.
- The study supports the widespread adoption of ACT as a valuable model for community mental health care.
- The role of the clinical coordinator was identified as a key factor in program success.