The effect of Assertive Community Treatment in Japan.
OBJECTIVE
The aim of this study was to evaluate the effects of the Assertive Community Treatment (ACT) program in a Japanese mental health service setting.


METHODS
This study was a randomized controlled trial. ACT was the intervention condition (n = 59), and the usual hospital-based rehabilitation program was the control condition (n = 59). Outcome indicators include in-patient days, psychiatric symptoms, social functioning, quality of life, and client satisfaction. The follow-up period was 12 months after the intervention.


RESULTS
We found a significant reduction of in-patient days for the ACT group demonstrated by t-test (t = 2.33, P = 0.02). However, the results of ancova did not show significant differences for in-patient days between the two groups (F = 1.85, P = 0.18). The depression score for Brief Psychiatric Rating Scale for the ACT group was significantly lower than the control group at the 12-month follow-up assessment (F = 5.57, P = 0.03). According to the t-test, the ACT group had a higher client satisfaction than the control group (t = 2.08, P = 0.05).


CONCLUSIONS
We concluded that ACT had a positive influence, as evidenced by a reduction of in-patient days, lower depressive symptoms, and higher client satisfaction.
Department of Psychiatric Rehabilitation, National Center of Neurology and Psychiatry, Tokyo, Japan. junito@ncnp.go.jp
J
J
Ito
I
I
Oshima
M
M
Nishio
T
T
Sono
Y
Y
Suzuki
K
K
Horiuchi
N
N
Niekawa
M
M
Ogawa
Y
Y
Setoya
F
F
Hisanaga
M
M
Kouda
K
K
Tsukada
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D010054:Brief Psychiatric Rating Scale; D003156:Community Mental Health Services / Q000592:standards*; D003863:Depression / Q000628:therapy*; D056348:Emotional Intelligence; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D012720:Severity of Illness Index; D016896:Treatment Outcome