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

Abstract

(Can J Psychiatry 1999;44:443-454)

Assertive community treatmentIssues from scientific and clinical literature with implications for practice

“…Latimer found that higher fidelity programs reduced hospital days 23 percent more than lower fidelity programs [27]. But, he cautioned that as mental health systems rely less on hospitals over time, the cost advantages of ACT will be harder to achieve and justification for the model will need to be based more on its clinical benefits.…”

“…Most studies conclude that ACT teams likely produce more effective outcomes if their measured fidelity is higher [27]; that is, if they squarely meet more DACTS criteria.…”

“…This reduction has been largely attributed to reduced hospital bed days [17,27]. The Cochrane (United Kingdom) review of ACT concluded that "ACT if correctly targeted to high users of inpatient care, can substantially reduce the costs of hospital care whilst improving outcome and patient satisfaction" [10].…”

Comparing the Costs and Acceptability of Three Fidelity Assessment Methods for Assertive Community Treatment

“…community treatment Fidelity to evidence-based models of care has been shown to predict better clinical outcomes for several types of practices (Cuddeback et al, 2013;Drake, Bond, & Essock, 2009;Latimer, 1999;J. H. McGrew, Bond, Dietzen, & Salyers, 1994;McGuire et al, in press; McHugo, Drake, Teague, & Xie, 1999;van Vugt et al, 2011).…”

Psychosocial rehabilitation: Approach of choice for those with serious mental illnesses

“…The model has been tested all over the world and similar results have been found [42][43][44][45]. ACT's effect on other outcomes (e.g., employment, living arrangements, etc.)…”