title: Clinical outcome of assertive community treatment (ACT) in a rural area in Denmark: a case-control study with a 2-year follow-up.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the effect of assertive community treatment (ACT) in the Tønder Region, South Jutland, where the first Danish ACT team was established to treat patients with severe and persistent mental illness (SMI).
  
  
  METHODS
  The study compares outcome over a 2-year period between recipients of ACT and standard community mental healthcare.
  
  
  RESULTS
  The study included 86 cases and 88 controls. At the time of recruitment, the cases and the controls did not differ significantly in demographic details and eligibility criteria. At the 2-year follow-up, the ACT patients showed a significant reduction in admissions, bed days and day hospital days, and a significant increase in the number of consultations compared with the controls. Adherence to outpatient services was higher in the ACT group. No significant improvements in psychopathology were found after 2 years, but a significant improvement in met needs and fewer unmet needs, indicating better functioning, occurred. Clients' satisfaction with care (Client Satisfaction Questionnaire, CSQ) was significantly higher among ACT patients than among controls.
  
  
  CONCLUSIONS
  The treatment of these patients in this ACT service has yielded promising results, suggesting that ACT treatment may be a useful intervention for SMI patients. However, large, rigorous, randomized control trials with ACT are needed in Europe as the existing evidence mainly comes from American studies.
authors.affiliation: Community Mental Health Centre, Tønder & Augustenborg Hospital, Augustenborg, Denmark. joeraaga@rm.dk
authors.forename: Jørgen
authors.initials: J
authors.lastname: Aagaard
authors.forename: Klaus
authors.initials: K
authors.lastname: Müller-Nielsen
mesh_terms: D000553:Ambulatory Care; D016022:Case-Control Studies; D003156:Community Mental Health Services / Q000379:methods*; D003718:Denmark; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D017060:Patient Satisfaction; D012424:Rural Population; D011795:Surveys and Questionnaires; D016896:Treatment Outcome