title: Comparison of assertive community treatment programs in urban Massachusetts and rural North Carolina.
abstract: In this pilot study, we compared teams in rural North Carolina (NC) and urban Massachusetts (MA) to examine the how sites vary the implementation of the Assertive Community Treatment (ACT) model to respond to state and local circumstances. We analysed and compared data on: client characteristics using the NC-TOPPS and a modified survey in MA; Regional Demographics and; Team Characteristics. Issues such as driving distances, lack of qualified clinical staff, scarcity of physicians, and more limited oversight created impediments to fidelity in rural NC, despite higher per patient funding. ACT is now national, but variability in implementation of the model remains.
authors.affiliation: Queensland Center for Mental Health Research, University of Queensland, Level 3 Dawson House, The Park, Wacol, QLD, 4076, Australia. dan_siskind@qcmhr.uq.edu.au
authors.forename: Dan
authors.initials: D
authors.lastname: Siskind
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wiley-Exley
mesh_terms: D000328:Adult; D003158:Community Psychiatry / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D008404:Massachusetts; D001523:Mental Disorders / Q000145:classification; D008875:Middle Aged; D009657:North Carolina; D010348:Patient Care Team; D010865:Pilot Projects; D012424:Rural Population; D014505:Urban Population