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Selected Annotated Bibliography for Assertive Community Treatment

Overview

Selected publications on assertive community treatment and related issues are listed in this annotated bibliography. The materials are grouped under the following headings:

Implementing Assertive Community Treatment
Critical Ingredients
Transfer to Less Intensive Services
Effectiveness Research
Special Populations
Consumers and Family Members

Implementing Assertive Community Treatment

Allness DJ, & Knoedler WH, (1999). The PACT Model of Community-Based Treatment for Persons with Severe and Persistent Mental Illnesses: A Manual for PACT Start-UP. Waldorf, MD: NAMI.

Practical guidance on starting and operating an assertive community treatment program from originators of the model. This manual describes the conceptual framework of assertive community treatment and details the day-today operations. Available from www.nami.org.

Stein LI, & Santos AB, (1998). Assertive Community Treatment of Persons with Severe Mental Illness. New York: Norton.

Dr. Leonard Stein, an originator of the assertive community treatment program, places assertive community treatment in the historical context of the treatment of persons with severe and persistent mental illness. Key principles of assertive community treatment are discussed along with issues related to financing and administration, and the operations of an effective assertive community treatment program.

Critical Ingredients

Lewin Group. (2000). Assertive Community Treatment Literature Review. Falls Church, VA: Author.

Describes variations in assertive community treatment programs and critical ingredients associated with successful consumer outcomes

McGrew J, & Bond GR, (1995). Critical ingredients of assertive community treatment: judgments of the experts. Journal of Mental Health Administration, 23,113-125.

Reports experts’ opinions on the ideal specifications of the assertive community treatment model.

Describes two subgroups of experts - those who advocated large multidisciplinary teams (100 or more clients) with day and evening shifts, and those who advocated smaller, often generalist, teams (approximately 50 clients).

Teague G, Bond G, & Drake, R, (1998). Program fidelity in assertive community treatment: development and use of a measure. American Journal of Orthopsychiatry, 68(2), 216-232.

Describes the development of the Dartmouth Assertive Community Treatment Scale (DACTS) and the results of its application to fifty diverse programs.

Transfer to Less Intensive Services

Salyer M, Masterton T, Fekete D, et al.(1998). Transferring clients from intensive case management: impact on client functioning. American Journal of Orthopsychiatry, 68(2), 233-245.

Evaluates the effects of transferring consumers from assertive community treatment to a less intensive case management programs

Stein LI, Barry KL, Van Dien G; Hollingsworth EJ; et al. (1999). Work and social support: a comparison of consumers who have achieved stability in ACT and clubhouse programs. Community Mental Health Journal. 35(2), 193-204.

Brings data to bare on the debate about whether consumers with serious mental illness, who have achieved stability in assertive community treatment programs can e transferred to less intensive services.

Effectiveness Research

Bond G, Drake R, Mueser K, & Latimer E, (2001) Assertive community treatment for people with severe mental illness: critical ingredients and impact on patients. Disease Management & Health Outcomes, 9(3), 141-159.

Summarizes results of 25 studies of the effectiveness of assertive community treatment. Includes information on cost effectiveness and fidelity.

Burns BJ. & Santos AB, (1995). Assertive community treatment: an update of randomized trials. Psychiatric Services, 46(7), 669 - 675.

Reviews outcomes of randomized controlled trials of assertive community treatment including studies of special populations (i.e., homeless, dual diagnoses)

Clark RE, Teague GB, Ricketts SD, et al (1998). Cost-effectiveness of assertive community treatment versus standard case management for person with co-occurring severe mental illness and substance use disorders. Health Services Research. 33:1285-1308.

Examines the cost-effectiveness of assertive community treatment in comparison to standard case management

Essock S, Frisman L, & Kontos N, (1998). Cost-effectiveness of assertive community treatment teams. American Journal of Orthopsychiatry, 68(2), 179-190.

Reports on the cost-effectiveness of assertive community treatment over an 18-month period

Latimer E, (1999). Economic impacts of assertive community treatment: a review of the literature. Canadian Journal of Psychiatry, 44, 443-454.

Focuses on economic impact of assertive community treatment on hospital use, emergency-room use, use of outpatient services, housing costs

Mueser KT, Bond GR, Drake RE, (1998). Models of community care for severe mental illness: a review of research on case management. Schizophrenia Bulletin, 24, 37-74.

Reviews results of 75 studies of community care for persons with severe mental illness and compares the effectiveness of assertive community treatment and intensive case management

Rosenheck R, & Neale M, (1998). Cost effectiveness of intensive psychiatric community care for high users of inpatient services. Archives of General Psychiatry, 55(5), 459-466.

Evaluates the costs of 10 intensive psychiatric community care programs at Department of Veterans Affairs medical centers in the northeastern United States.

Special Populations

Rural

McDonel E, Bond G, Salyers M, et al, (1997). Implementing assertive community treatment programs in rural settings. Administration and Policy in Mental Health, 25(2), 153-173.

Reports results of a controlled evaluation of a rural adaptation of assertive community treatment. Describes challenges to implementation of complex service models.

Santos A., Deci, P., Dias, J., Sloop, T., Hiers, T., & Bevilcqua, J. (1993). Providing assertive community treatment for severely mentally ill patients in a rural area. Hospital and Community Psychiatry, 44(1), 34-39.

Addresses differences between traditional mental health services and urban and rural assertive community treatment programs

Homeless

Lehman A, Dixon L, Kernan E, et al, (1997). A randomized trial of assertive community treatment for homeless persons with severe mental illness. Archives of General Psychiatry, 54(11), 1038-1043.

Reports effectiveness of assertive community treatment compared to usual community services

Tsemberis S, (1999). From streets to homes: an innovative approach to supported housing for homeless adults with psychiatric disabilities. Journal of Community Psychology, 27(2), 225-241

Describes a supported housing program that provides immediate access to permanent independent housing to individuals who are homeless and have psychiatric disabilities

Morse G, Calsyn R, Klinkenberg W, Trusty M, et al.,(1997). An experimental comparison of three types of case management for homeless mentally ill persons. Psychiatric Services, 48(497-503).

Compares the effectiveness of assertive community treatment and brokered case management for people with severe mental illness who are homeless or at risk of homelessness

Dual Diagnoses

Drake R, McHugo G, Clark R, et al. (1998). Assertive community treatment for patients with co-occurring severe mental illness and substance use disorder: a clinical trail. American Journal of Orthopsychiatry, 68(2), 201-213.

Compared the effectiveness of integrated mental health and substance abuse treatment within an assertive community treatment program with a standard case management approach

Consumers Involved in the Criminal Justice System

Solomon P, Draine J, (1995). One-year outcomes of a randomized trial of case management with seriously mentally ill clients leaving jail. Evaluation Review, 19, 256-274.

Compares the effectiveness of assertive community treatment and two case management conditions on seriously mentally ill inmates leaving jail

Consumers & Family Members

Dixon L, Stewart B, Krauss N, Robbins J, et al., (1998). The participation of families of homeless persons with severe mental illness in an outreach intervention. Community Mental Health Journal, 34(3), 251-259.

Describes the role of a family outreach worker on an assertive community treatment team and how the family outreach worker interacts with homeless persons with severe mental illness and their families

Felton C, Stastny P, Shern D, Blanch A, et al.(1995). Consumers as peer specialists on intensive case management teams: impact on clients. Psychiatric Services, 46(10), 1037-1044.

Examines the effect of peer specialists on consumers’ quality of life and reduction in major life problems

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