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So what shall we do about assertive community treatment?

Published online by Cambridge University Press:  18 May 2011

Sonia Johnson
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Abstract

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The usefulness of Assertive Community Treatment (ACT) in European countries with well-developed community care systems has been disputed, despite considerable relevant literature. This paper aims to assess reasons for and against implementing ACT in such countries. ACT may not be useful where generic community mental health teams are not yet well-developed, where admission rates are already low, or where an alternative model based on close integration of a full range of types of care is in place. Good reasons for introducing ACT include listening to patients' preferences, being able to monitor a high risk group of patients more successfully, good staff satisfaction, and the potential for using ACT teams as a platform for delivering interventions for difficult to treat psychosis. The ACT model is more likely to thrive in future if a recovery orientation can be adopted.

Type
Editorials
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 2 , June 2008 , pp. 110 - 114
Copyright
Copyright © Cambridge University Press 2008

References

REFERENCES

Becker, T. & Kilian, R. (2006). Psychiatric services for people with severe mental illness across western Europe: what can be generalized from current knowledge about differences in provision, costs and outcomes of mental health care? Ada Psychiatrica Scandinavica 113, 9–16.CrossRefGoogle Scholar
Becker, T., lsmann, S., Knudsen, H.C., Martiny, K., Amaddeo, F., Herran, A., Knapp, M, Schene, A.H., Tansella, M., Thornicroft, G. & Vazquez-Barquero, J.L. (2002). Provision of services for people with schizophrenia in five European regions. Social Psychiatry & Psychiatric Epidemiology 37(10), 465–474.CrossRefGoogle ScholarPubMed
Billings, J., Johnson, S., Bebbington, P., Greaves, A., Priebe, S., Muijen, M, Ryrie, I., Watts, J., White, I. & Wright, C. (2003). Assertive outreach teams in London: Staff experiences and perceptions – Pan-London Assertive Outreach Study, Part 2. British Journal of Psychiatry 183, 139–147.CrossRefGoogle ScholarPubMed
Bond, G.R., Drake, R.E., Mueser, K.T. & Latimer, E. (2001). Assertive community treatment for people with severe mental illness: critical ingredients and impact on patients. Disease Management and Health Outcomes 9, 141–159.CrossRefGoogle Scholar
Bonsack, C, Adam, L., Haefliger, T., Besson, J. & Conus, P. (2005). Difficult-to-engage patients: A specific target for time-limited assertive outreach in a Swiss setting. Canadian Journal of Psychiatry-Revue Canadienne de Psychiatrie 50, 845–850.CrossRefGoogle Scholar
Burns, T. (2000). Models of community treatments in schizophrenia: do they travel? Ada Psychiatrica Scandinavica, Supplementum No. 102, 11–14.CrossRefGoogle Scholar
Burns, T. (2008). Case management and assertive community treatment: what is the difference? Epidemiologia e Psichiatria Sociale 17, 99–105.CrossRefGoogle ScholarPubMed
Burns, T., Fioritti, A., Holloway, F., Malm, U. & Roessler, W. (2001). Case management and assertive community treatment in Europe. Psychiatric Services 52, 631–636.CrossRefGoogle ScholarPubMed
Burns, T., Catty, J. & Wright, C. (2006). Deconstructing home-based care for mental illness: can one identify the effective ingredients? Ada Psychiatrica Scandinavica 113, 33–35.CrossRefGoogle Scholar
Burns, T., Catty, J., Dash, M., Roberts, C, Lockwood, A. & Marshall, M. (2007). Use of intensive case management to reduce time in hospital in people with severe mental illness: systematic review and meta-regression. British Medical Journal 335, 336–340.CrossRefGoogle ScholarPubMed
Calsyn, R.J., Klinkenberg, W.D., Morse, G.A. & Lemming, M.R. (2006). Predictors of the working alliance in assertive community treatment. Community Mental Health Journal 42, 161–175.CrossRefGoogle ScholarPubMed
Care Service Improvement Partnership, Royal College of Psychiatrists & Social Care Institute for Excellence (2007). A Common Purpose: Recovery in Future Mental Health Services. Social Care Institute for Excellence: London.Google Scholar
Craig, T.K., Garety, P., Power, P., Rahaman, N., Colbert, S., Fornells-Ambrojo, M. & Dunn, G. (2004). The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. British Medical Journal 329, 1067–1070.CrossRefGoogle ScholarPubMed
Dixon, L.B. (2000). Assertive community treatment: twenty-five years of gold. Psychiatric Services 51, 759–765.CrossRefGoogle ScholarPubMed
Drake, R.E. & Deegan, P.E. (2008). Are assertive community treatment and recovery compatible? Commentary on “ACT and recovery: Integrating evidence-based practice and recovery orientation on assertive community treatment teams. Community Mental Health Journal 44,75–77.CrossRefGoogle ScholarPubMed
Fakhoury, W.K.H., White, I., Priebe, S. & Plao, S.G. (2007). Be good t o your patient – How the therapeutic relationship in the treatment of patients admitted to assertive outreach affects rehospitalization. Journal of Nervous and Mental Disease 195, 789–791.CrossRefGoogle Scholar
Fiander, M., Burns, T., McHugo, G.J. & Drake, R.E. (2003). Assertive community treatment across the Atlantic: comparison of model fidelity in the UK and USA. British Journal of Psychiatry 182, 248–254.CrossRefGoogle ScholarPubMed
Garety, P.A., Craig, T.K.J., Dunn, G., Fornells-Ambrojo, M., Colbert, S., Rahaman, N., Reed, J., & Power, P. (2006). Specialised care for early psychosis: symptoms, social functioning and patient satisfaction-Randomised controlled trial. British Journal of Psychiatry 188, 37–45.CrossRefGoogle ScholarPubMed
Glover, G., Arts, G. & Babu, K.S. (2006). Crisis resolution/home treatment teams and psychiatric admission rates in England. British Journal of Psychiatry 189, 441–445.CrossRefGoogle ScholarPubMed
Gold, P.B., Meisler, N., Santos, A.B., Carnemolla, M.A., Williams, O.H. & Keleher, J. (2006). Randomized trial of supported employment integrated with assertive community treatment for rural adults with severe mental illness. Schizophrenia Bulletin 32, 378–395.CrossRefGoogle ScholarPubMed
Hoult, J., Reynolds, I., Charbonneau-Powis, M., Coles, P. & Briggs, J. (1981). A controlled study of psychiatric hospital versus community treatment – the effect on relatives. Australian and New Zealand Journal of Psychiatry 15, 323–328.CrossRefGoogle ScholarPubMed
Johnson, S., Nolan, F., Hoult, J., White, I.R., Bebbington, P., Sandor, A., McKenzie, N., Patel, S.N. & Pilling, S. (2005a). Outcomes of crises before and after introduction of a crisis resolution team. British Journal of Psychiatry 187, 68–75.CrossRefGoogle ScholarPubMed
Johnson, S., Nolan, F., Pilling, S., Sandor, A., Hoult, J., McKenzie, N., White, I.R., Thompson, M. & Bebbington, P. (2005b). Randomised controlled trial of acute mental health care by a crisis resolution team: the north Islington crisis study. British Medical Journal, 331, 599.CrossRefGoogle Scholar
Killaspy, H. (2007). Assertive community treatment in psychiatry. British Medical Journal 335, 311–312.CrossRefGoogle ScholarPubMed
Killaspy, H., Bebbington, P., Blizard, R., Johnson, S., Nolan, F., Pilling, S. & King, M. (2006). The REACT study: randomised evaluation of assertive community treatment in north London. British Medical Journal 332, 815–818A.CrossRefGoogle ScholarPubMed
Lasalvia, A. & Ruggeri, M. (2007). Assessing the outcome of community-based psychiatric care: Building a feedback loop from ‘real world’ health services research into clinical practice. Ada Psychiatrica Scandinavica 116, 6–15.CrossRefGoogle Scholar
Lloyd-Evans, B., Johnson, S. & Slade, M. (2007). Assessing the content of mental health services: a review of measures. Social Psychiatry and Psychiatric Epidemiology 42, 673–682.CrossRefGoogle ScholarPubMed
Marshall, M. (2008). What have we learnt from 40 years of research on intensive case management? Epidemiologia e Psichiatria Sociale 17, 106–109.CrossRefGoogle ScholarPubMed
Mezzina, R. & Vidoni, D. (1995). Beyond the mental hospital: crisis intervention and continuity of care in Trieste. A four year follow-up study in a community mental health centre. International Journal of Social Psychiatry 41, 1–20.CrossRefGoogle Scholar
Petersen, L., Jeppesen, P., Thorup, A., Abel, M.J., Ohlenschlaeger, J., Christensen, T.O., Krarup, G., Jorgensen, P. & Nordentoft, M. (2005). A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness. British Medical Journal 331, 602–605.CrossRefGoogle ScholarPubMed
Priebe, S., Fakhoury, W., Watts, J., Bebbington, P., Burns, T., Johnson, S., Muijen, M., Ryrie, I., White, I. & Wright, C. (2003). Assertive outreach teams i n London: patient characteristics and outcomes: Pan-London Assertive Outreach Study, Part 3. British Journal of Psychiatry 183, 148–154.CrossRefGoogle Scholar
Rosen, A., Mueser, K.T. & Teesson, M. (2007). Assertive community treatment-issues from scientific and clinical literature with implications for practice. Journal of Rehabilitation Research and Development 41, 813–825.CrossRefGoogle Scholar
Salvador-Carulla, L., Tibaldi, G., Johnson, S., Scala, E., Romero, C. & Munizza, C. (2005). Patterns of mental health service utilisation in Italy and Spain – An investigation using the European Service Mapping Schedule. Social Psychiatry and Psychiatric Epidemiology 40, 149–159.CrossRefGoogle ScholarPubMed
Salyers, M.P. & Tsemberis, S. (2007). ACT and recovery: Integrating evidence-based practice and recovery orientation on assertive community treatment teams. Community Mental Health Journal 43, 619–641.CrossRefGoogle ScholarPubMed
Smith, L. & Newton, R. (2007). Systematic review of case management. Australian and New Zealand Journal of Psychiatry 41, 2–9.CrossRefGoogle ScholarPubMed
Stein, L.I. & Test, M.A. (1980). Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry 37, 392–397.CrossRefGoogle ScholarPubMed
Sytema, S., Wunderink, L., Bloemers, W., Roorda, L. & Wiersma, D. (2007). Assertive community treatment in the Netherlands: a randomized controlled trial. Ada Psychiatrica Scandinavica 116, 105–112.CrossRefGoogle ScholarPubMed
Thornicroft, G. & Tansella, M. (2004). Components of a modern mental health service: a pragmatic balance of community and hospital care: Overview of systematic evidence. British Journal of Psychiatry 185, 283–290.CrossRefGoogle ScholarPubMed
Tyrer, P. (2007). The future of specialist community teams in the care of those with severe mental illness. Epidemiologia e Psichiatria Sociale 16, 225–230.CrossRefGoogle ScholarPubMed
Tyrer, P., Balod, A., Germanavicius, A., Mcdonald, A., Varadan, M. & Thomas, J. (2007). Perceptions of assertive community treatment in the UK and Lithuania. International Journal of Social Psychiatry 53, 498–506.CrossRefGoogle ScholarPubMed
van Veldhuizen, J.R. (2007). FACT: A Dutch version of ACT. Community Mental Health Journal 43, 421–433.CrossRefGoogle ScholarPubMed
Wright, C, Burns, T., James, P., Billings, J., Johnson, S., Muijen, M.P.S., Ryrie, I., Watts, J. & White, I. (2003). Assertive outreach teams in London: Models of Operation. Pan London Assertive Outreach Study Part I. British Journal of Psychiatry 183, 132–138.Google ScholarPubMed