Assertive community treatment for frequent users of psychiatric hospitals in a large city: A controlled study

Abstract

Evaluated a large-city adaptation of the assertive community treatment (ACT) model (Stein & Test, 1980). Outcomes were examined after 1 year for 82 clients, averaging over 17 lifetime psychiatric hospitalizations, randomly assigned either to ACT or to a drop-in (DI) center. After 1 year, 76% of the ACT clients and only 7% of DI clients were involved in the respective programs. The ACT team averaged 2 home and community visits per week to each client. ACT clients averaged significantly fewer state hospital admissions and state hospital days than did DI clients. ACT clients reported greater satisfaction with program services, fewer contacts with the police, and less difficulty with practical problems associated with psychiatric readmission. More ACT clients were known to have stable community housing. Annual per-client treatment costs for ACT were estimated to be $1,500 less than for DI.

Health care reform and rural mental health: Severe mental illness

“…Assertive community treatment has been demonstrated to be an effective strategy for serving the seriously mentally ill (Stein & Test, 1985;Stein & Test 1980;Torrey, 1986;Hoult, Rosen & Reynolds, 1984;Bond, Miller, Krumwied, & Ward, 1988;Bond, Witheridge, Dincin, Wasmer, Webb, & DeGraaf-Kaser, 1990;Bush, Langford, Rosen, & Gott, 1990;Olfson, 1990;Mechanic, 1991). Model programs consist of multidisciplinary teams which provide continuous care to a limited number of severely mentally ill (appx.…”

Economic Impacts of Assertive Community Treatment: A Review of the Literature

“…Bond and others (39) Bush and others (40) Test and others (41); Test and others (42) Marks and others (21) Rosenbeck and others-NP-I (45)…”

Providing independent housing for the homeless mentally ill: A novel approach to evaluating long‐term longitudinal housing patterns

“…The intensity of case management was manipulated based on prior work showing that intensive case management can be a cost-effective tool for improving the lives of individuals with chronic and severe mental illness and for helping them remain stable in the community (Bond et al, 1990;Stein & Test, 1980). Half of the clients in our study were assigned to a comprehensive case management condition and half were assigned to the traditional level of case management available in San Diego County.…”