title: Assertive community treatment and associations with substance abuse problems.
abstract: This study examined the associations between substance abuse problems in severely mentally ill patients, outcome and Assertive Community Treatment (ACT) model fidelity. In a prospective longitudinal study, ACT model fidelity and patient outcomes were assessed in 20 outpatient treatment teams using the Health of the Nation Outcome Scales, Camberwell Assessment of Needs short appraisal schedule and measures of service use. Five hundred and thirty severely mentally ill patients participated in the study. Substance abuse problems were assessed three times during a 2-year follow-up period. This study found that among patients with severe mental illness, patients with an addiction problem had more serious psychosocial problems at baseline. Substance abuse problems showed improvement over time, but this was not associated with ACT model fidelity. The study indicates that investment by teams to improve a patient's psychosocial situation can lead to improvements on substance problems.
authors.affiliation: Department of Reintegration, Trimbos-institute, Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands, mvugt@trimbos.nl.
authors.forename: Maaike D
authors.initials: MD
authors.lastname: van Vugt
authors.forename: Hans
authors.initials: H
authors.lastname: Kroon
authors.forename: Philippe A E G
authors.initials: PA
authors.lastname: Delespaul
authors.forename: Cornelis L
authors.initials: CL
authors.lastname: Mulder
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000379:methods* / Q000706:statistics & numerical data; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000628:therapy*