Assertive community treatment of the mentally ill: service model and effectiveness.
OBJECTIVE
To provide a description of the service delivery model of an assertive community treatment (ACT) team in the management of a group of severely mentally ill patients and examine the effectiveness of this team in reducing readmissions to a psychiatric inpatient service.


METHODS
A clinical case audit was performed on a single day in September 2001. Admission episodes and duration were collected for patients registered with the team in the 12 month period prior to ACT and for a period of 12 months ending on the day of the audit. Forty-three patients were registered with the team at the time of data collection. The majority (79%) were diagnosed with schizophrenia and there were high rates of comorbidity (76%) and disability (mean Global Assessment of Functioning score 45.9). The main outcome measures were the number of readmissions and readmission days before and after the institution of ACT.


RESULTS
The mean number of readmission days reduced from 70.9 to 10.2 (p<0.05) following the institution of ACT.


CONCLUSIONS
Assertive community treatment conducted in a naturalistic clinical environment is effective in significantly reducing the number of readmission days in a group of patients suffering from long-term and persistent severe mental illness.
Udechuku
Adaobi
A
North East Mobile Support and Treatment Service, Austin Health, Heidelberg, Vic., Australia.
Olver
James
J
Hallam
Karen
K
Blyth
Frances
F
Leslie
Melissa
M
Nasso
Marina
M
Schlesinger
Paul
P
Warren
Lorraine
L
Turner
Miles
M
Burrows
Graham
G
D019090:Case Management / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D003156:Community Mental Health Services / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D003695:Delivery of Health Care / Q000191:economics / Q000592:standards; D039721:Diagnostic and Statistical Manual of Mental Disorders; D017048:Health Care Costs / Q000706:statistics & numerical data; D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008485:Medical Audit; D001523:Mental Disorders / Q000175:diagnosis / Q000534:rehabilitation* / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D010343:Patient Admission; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy; D012720:Severity of Illness Index
D011619:Psychotropic Drugs