Assertive Community Treatment and Case Management for Schizophrenia

Abstract

This review examines the impact of assertive community treatment (ACT) and case management models on the use of inpatient hospitalization and other community mental health services, costs, and other clinical and social outcomes. ACT programs have been found to reduce hospitalization and increase use of community mental health services at an equivalent or reduced cost. Greater fidelity to the ACT model produced better outcomes. The impact of case management models is less consistent, but intensive case management programs also have been found to reduce hospitalization. We discuss limitations in past research and recommend future directions.

Economic Impacts of Assertive Community Treatment: A Review of the Literature

“…Clinical arguments can then be invoked to justify the setting up ofACT services: the evidence that ACT results in improved clinical and satisfaction outcomes for the majority of its target clientele has now been well-documented in several literature reviews (for example, 4,7,8,83 …”

“…The most consistent effect of ACT is the reduction of time spent in hospital (7,8,70,71). Where data in the identified studies allowed, the percentage reduction in hospital days was calculated (Note 3).…”

Soutien d’intensité variable (SIV) et rétablissement : que nous apprennent les études expérimentales et quasi expérimentales ?

“…Les études sur le modèle ACT en comparaison avec un autre, ont été exclues. D'autres articles ont été identifiés à partir de listes de références des synthèses répertoriées (Holloway et al, 1995 ;Scott et Dixon, 1995 ;Baronet et Gerber, 1998 ;Marshall et al, 1998 ;Mueser et al, 1998 ;Ziguras et Stuart, 2000 ;Aubry et al, 2004 ;Corrigan et al, 2008 ;Dieterich et al, 2011). Ce processus initial a permis d'identifier 89 études (dont plusieurs sont rapportées en plusieurs articles).…”

Hospital Outcome Measures following Assertive Community Treatment in Edmonton, Alberta

“…Substantial research now exists on this treatment model, including reviews of ACT and its application to populations, both rural and urban, in the United States (US) (6)(7)(8)(9)(10)(11)(12).Cana· dian data are more limited, despite the implementation of ACT in several Canadian settings. One ofthe more receIftCa· nadian studies using a pre-post study design repo~.aQn a sample of 59 homeless individuals.…”