title: Effectiveness of assertive community management in Singapore.
abstract: BACKGROUND
  Assertive Community Treatment (ACT) was introduced in the 1970s as a comprehensive and assertive approach to community-based case management of patients with chronic and serious mental illness. Launched in Singapore in 2003, the Assertive Community Management (ACM) was modelled after the ACT, but with the main difference of 24 hour availability for the latter only. In line with the move towards de-institutionalisation of psychiatric patients, ACM was introduced to provide a mobile community-based multidisciplinary team approach to manage patients with severe chronic psychiatric illness. This article aims to evaluate and provide an update on this service programme in Singapore following an earlier study by Fam Johnson in 2007.
  
  
  METHODS
  A naturalistic and retrospective study was conducted. One hundred and fifty-five patients recruited into ACM from 1 September 2008 to 1 September 2009 and had completed 1 year of ACM were included in our study. Outcomes were defined as number of admissions (NOA) and length of stay (LOS) one year before and one year following induction into the programme. Baseline socio-demographic factors were also investigated to see if they predicted outcome with ACM.
  
  
  RESULTS
  The mean NOA was 1.9 pre-ACM and 0.6 post-ACM, with mean reduction in NOA of 1.3 (P <0.01). The mean LOS was 72.2 days pre-ACM and 17.1 days post ACM, mean reduction in LOS 55.1 days (P <0.01). In addition, it was found that gender, diagnoses and ethnicity were not predictive of the outcome measures of NOA or LOS.
  
  
  CONCLUSIONS
  ACM in Singapore had been well established since its inception and continued to show effectiveness in reducing inpatient hospitalisation among the chronically mentally ill.
authors.affiliation: Community Psychiatry Department, Institute of Mental Health, 10 Buangkok View, Singapore 539747. lambert.low@mohh.com.sg
authors.forename: Lambert
authors.initials: L
authors.lastname: Low
authors.forename: Yu Yuan
authors.initials: YY
authors.lastname: Tan
authors.forename: Boon Leng
authors.initials: BL
authors.lastname: Lim
authors.forename: Weng Cheong
authors.initials: WC
authors.lastname: Poon
authors.forename: Cheng
authors.initials: C
authors.lastname: Lee
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy; D019090:Case Management; D003156:Community Mental Health Services; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D011618:Psychotic Disorders / Q000628:therapy; D012559:Schizophrenia / Q000628:therapy; D012846:Singapore