title: From deinstitutionalization to recovery-oriented assertive community treatment in Hong Kong: What we have achieved.
abstract: This paper explored the effectiveness of Assertive Community Treatment (ACT) for severely ill mental patients during a period of rapid deinstitutionalization in Hong Kong. We employed a flanking historical control design. The treatment group comprised 70 participants with 3 or more admissions to psychiatric hospitals within the preceding 12 months, and received ACT. Two historical control groups (C1 and C2), each 70 participants, with similar inclusion criteria flanking the recruitment period of treatment group, were identified and received Treatment as Usual (TAU). Outcome data were measured at baseline, 6, 12 and 18 months of intervention. Readmission rates, bed-days, emergency room visits and days of missing medical appointments improved with time during the deinstitutionalization process, irrespective of treatment modality. In addition, ACT had superior effect in most of these outcome parameters, compared to the control groups. We reported that the current model of ACT, with a relatively small case load per case manager, round the clock services, multidisciplinary team approach, with psychiatrists integrated in the services and case managers responsible for health and social care, is an effective intervention for helping people with mental illness who pursue their chosen independent living in the community.
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region. Electronic address: leecc@ha.org.hk.
authors.forename: Chi C
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Shu K
authors.initials: SK
authors.lastname: Liem
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Joey
authors.initials: J
authors.lastname: Leung
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Vicky
authors.initials: V
authors.lastname: Young
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Kitty
authors.initials: K
authors.lastname: Wu
authors.affiliation: Hospital Authority, Head Office, 147B Argyle Street, Kowloon, Hong Kong Special Administrative Region.
authors.forename: Kenny K
authors.initials: KK
authors.lastname: Wong Kenny
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Sui K
authors.initials: SK
authors.lastname: Yuen
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Wai F
authors.initials: WF
authors.lastname: Lee
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Tom
authors.initials: T
authors.lastname: Leung
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Mannix
authors.initials: M
authors.lastname: Shum
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kwong
authors.affiliation: Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong Special Administrative Region.
authors.forename: William
authors.initials: W
authors.lastname: Lo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019090:Case Management; D003156:Community Mental Health Services; D003688:Deinstitutionalization / Q000379:methods*; D005260:Female; D006723:Hong Kong; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D057187:Independent Living; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010865:Pilot Projects; D016896:Treatment Outcome
keywords: Case management; Frequent admission; Mental illness; Outcome