scholarly journals Setting up an assertive community treatment service

1996 ◽  
Vol 2 (4) ◽  
pp. 143-150 ◽  
Author(s):  
Andrew Kent ◽  
Tom Burns

The last 20 years have witnessed a surge of interest in assertive community treatment (ACT) for the severely mentally ill (Drake & Burns, 1995). ACT aims to help people who would otherwise be in and out of hospital on a ‘revolving door’ basis live in the community and enjoy the best possible quality of life. Services based on the ACT model seek to replace the total support of the hospital with comprehensive, intensive and flexible support in the community, delivered by an individual key worker or core services team. They are organised in a way that optimises continuity of care across different functional areas and across time.

1993 ◽  
Vol 44 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Alberto B. Santos ◽  
Paul A. Deci ◽  
Kerry R. Lachance ◽  
James K. Dias ◽  
Theresa B. Sloop ◽  
...  

2005 ◽  
Vol 13 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Adaobi Udechuku ◽  
James Olver ◽  
Karen Hallam ◽  
Frances Blyth ◽  
Melissa Leslie ◽  
...  

Objective: To provide a description of the service delivery model of an assertive community treatment (ACT) team in the management of a group of severely mentally ill patients and examine the effectiveness of this team in reducing readmissions to a psychiatric inpatient service. Method: A clinical case audit was performed on a single day in September 2001. Admission episodes and duration were collected for patients registered with the team in the 12 month period prior to ACT and for a period of 12 months ending on the day of the audit. Forty-three patients were registered with the team at the time of data collection. The majority (79%) were diagnosed with schizophrenia and there were high rates of comorbidity (76%) and disability (mean Global Assessment of Functioning score 45.9). The main outcome measures were the number of readmissions and readmission days before and after the institution of ACT. Results: The mean number of readmission days reduced from 70.9 to 10.2 (p < 0.05) following the institution of ACT. Conclusion: Assertive community treatment conducted in a naturalistic clinical environment is effective in signi?cantly reducing the number of readmission days in a group of patients suffering from long-term and persistent severe mental illness.


2006 ◽  
Vol 23 (4) ◽  
pp. 134-139 ◽  
Author(s):  
Nathan Gregory ◽  
Rob Macpherson

AbstractAssertive Community Treatment (ACT) has developed globally as a model of community care for the severely mentally ill. However, in the United Kingdom there is mixed evidence regarding improvements in outcome and concerns about ACT teams having poor fidelity to the original ACT model.Objective: This study presents the fidelity characteristics of an established ACT team serving Gloucester City. It describes service user demographic and illness data and compares these findings to other important studies in the United Kingdom.Method: The Dartmouth Assertive Community Treatment Scale was applied to rate the Gloucester ACT team's fidelity characteristics. The Gloucester Caseload Project Demographic Pro-Forma was collected from all of the team's 79 service users.Results: The population of severely mentally ill ACT service users in Gloucester City were an older and more “disabled” group compared to the classic ACT studies. Furthermore, although findings indicate a high level of fidelity to the original ACT model, the team it is still associated with high levels of inpatient treatment.Conclusion: High fidelity ACT services appear to be associated with high admission rates. Therefore teams should not be viewed as alternatives to hospital admission but have goals of improving engagement and social functioning. Furthermore, findings have allowed the team to benchmark its service and target areas for further service development. More consistent reporting of fidelity data on ACT research would facilitate comparison across different services.


2016 ◽  
Vol 8 (1) ◽  
pp. 212
Author(s):  
Robert John Zagar ◽  
Agata Karolina Zagar ◽  
Kenneth G. Busch ◽  
James Garbarino ◽  
Terry Ferrari ◽  
...  

<p>The goal is to share policy implications of sensitive, specific internet-based tests in place of current approaches to lowering violence, namely fewer mass murders, suicides, homicides. When used, internet-based tests save lives and money. From 2009-2015, a Chicago field test had 324 fewer homicides (saving $2,089,848,548, <em>ROI</em>=6.42). In 60 yrs., conventional approaches for high risk persons (e.g.,. inappropriately releasing poor, severely mentally ill) led to unnecessary expense including yearly: (a) 300 mass murders (59% demonstrating psychiatric conditions); (b) 1-6% having costly personnel challenges; (c) 2,100,000 “revolving door” Emergency-Room (ER) psychiatric admissions (41,149 suicides, 90% mentally ill); (d) 10,000,000 prisoners (14,146 homicides, 20% psychiatric challenges). Current metrics fail [success rates from 25%-73%: (1) for background checks (25%); (2) interviews (<em>M</em>=46%); (3) physical exams (<em>M</em>=49%); (4) other tests (<em>M</em>=73%)]. Internet-based tests are simultaneously sensitive (97%), specific (97%), non-discriminatory, objective, inexpensive, $100/test, require 2-4 hrs.</p>


Author(s):  
Gwendolyn Watkins Johnson ◽  
Aurelio José Figueredo ◽  
Richard R. Bootzin ◽  
Michael R. Berren ◽  
Lee H. Sechrest

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