Assertive Community Treatment (ACT) in Singapore: a 1-year follow-up study.
BACKGROUND
Assertive Community Treatment (ACT) provides community-based treatment to patients with severe and persistent psychiatric illnesses, so that they may continue to live and function in the community as they receive psychiatric care. This study aimed to examine the effects of ACT on the outcome of patients over a 1-year period in an Asian population.


METHODS
This naturalistic and retrospective cohort study examined the effects of ACT on 100 patients who had completed 1 year of ACT. Parameters used to measure primary outcome were i) number of admissions (NOA) and ii) total length of stay (LOS) in days. Secondary outcome compared the employment status of patients before and after ACT. Paired sample analyses were performed using SPSS.


CONCLUSIONS
The mean reduction in NOA 1 year post-ACT was 57.1%. The mean reduction in LOS 1 year post-ACT was 61.9%. The median reduction for NOA and LOS were both statistically significant (P <0.01). Thirty-seven patients were employed compared to 6 before the programme, a statistically significant effect on employment (odds ratio 9.69, P <0.01).


CONCLUSIONS
ACT appears effective in reducing the frequency and duration of admissions for patients in Singapore. The employment status of patients also showed improvement over the course of study.
Fam
Johnson
J
Department of Community Psychiatry, Institute of Mental Health, Singapore. jhnsnfm@gmail.com
Lee
Cheng
C
Lim
Boon-Leng
BL
Lee
Kiang-Kim
KK
D000328:Adult; D015331:Cohort Studies; D003156:Community Mental Health Services / Q000379:methods* / Q000592:standards; D003158:Community Psychiatry / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012846:Singapore; D012917:Social Adjustment