Family Support in Assertive Community Treatment: An Analysis of Client Outcomes

Abstract

Assertive Community Treatment (ACT) is an outreach-based case management model that assists people with severe mental illness through an intensive and integrated approach. In this program, a multidisciplinary team provides medical and psychosocial services. The purpose of this study was to examine the effectiveness of the following two ACT intervention strategies: "replacement" (supporting the clients) versus "backup" (supporting family members who provide care to clients). Admission days, psychiatric symptoms, quality of life, self-efficacy, and service satisfaction ware evaluated as outcome variables. To identify effective methods of supporting family members, clients living with family were divided into two groups based on the amount and types of services received-the backup group and the replacement group. ANCOVA was used to compare the outcomes between the two groups. The replacement group displayed significantly better psychiatric symptoms, social functioning, self-efficacy, and service satisfaction scores. No differences in admission days or quality of life were found. Clients provided more support directly to clients themselves than to family members was found to have better client outcomes in improving psychiatric symptoms, social functioning, and self-efficacy, resulting in higher levels of service satisfaction. This indicates that society should reduce the responsibility of the family and share responsibility for the care of people with mental illness to effectively improve outcomes for people with mental illnesses.

Sources of social support and community integration among persons with serious mental illnesses in Korea

“…Given the dominance of a collectivist cultural orientation, family members are vulnerable to shame, prejudice and discrimination for having a coresiding mentally ill member. Sono et al (2012) documented that family members often expressed anxiety about their future, emotional burden, and difficulty of family life. Family members might not have the time to engage in their own networks or participate in the labor market.…”

Validity and reliability of the Family Empowerment Scale for caregivers of adults with mental health issues

“…the Carers Act, carer's assessment) in the United Kingdom, which was reported in special issues of several journals in Japan (Kageyama 2013). Mental health nurses have become increasingly involved with family caregivers, including providing individual consultations in home visiting nursing (Toyoshima & Matsuda 2010) and assertive community treatment (Sono et al 2012). It has also been recommended that mental health nurses take on a new role as partners of family caregivers (Amagai 2006, Kageyama 2013.…”

Specialisation and marginalisation: how the assertive community treatment debate affects individuals with complex mental health needs

“…At the same time, it may be appropriate to modify direct application of Western-based community mental health models of care in favour of more culturally appropriate and sustainable models, such as those placing greater emphasis on family support. 25,29 While noting the necessity for contextually appropriate adaptations of imported healthcare models, policy makers and clinicians must ensure that the evidence-based, critical ingredients are not lost. Researchers must be resourced to rigorously evaluate emerging approaches to inform investment in the most clinically and cost-effective models that 'best fit' different settings.…”