A national survey of assertive community treatment services in England.
BACKGROUND
Assertive community treatment (ACT) teams have been implemented across England since 1999. Although successful at engaging clients, the model has failed to show the same clinical effectiveness in trials in Europe as in the US and Australia.


OBJECTIVE
To investigate current ACT provision in England, aims of treatment and team managers' views of the effectiveness of ACT and the most important interventions.


METHODS
Postal survey of managers of all services in England identifying as ACT teams.


RESULTS
A total of 104/187 (56%) completed questionnaires were received. The majority of teams were in urban or mixed urban/rural areas. One third (36%) of teams had no psychiatrist, one half (48%) had no psychologist and less than a fifth (18%) had designated inpatient admission beds. The areas of intervention rated as most important by team managers could be delivered by non-professionally trained staff (engagement, accommodation, finances). The majority of managers reported positive clinical outcomes but only one third had collected data to support this. One third of teams were undergoing review or being reconfigured or closed.


CONCLUSIONS
Successful client engagement is not being used as a vehicle to deliver evidence-based interventions. Many ACTs in England are not adequately staffed to deliver these.
Ghosh
Ratna
R
General Adult Psychiatry, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK. ratnaghosh78@yahoo.com
Killaspy
Helen
H
D003156:Community Mental Health Services / Q000379:methods* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D019538:Health Care Surveys / Q000379:methods* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D017064:Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires