Abstract
This article describes the critical ingredients of the assertive community treatment (ACT) model for people with severe mental illness and then reviews the evidence regarding its effectiveness and cost effectiveness. ACT is an intensive mental health program model in which a multidisciplinary team of professionals serves patients who do not readily use clinic-based services, but who are often at high risk for psychiatric hospitalization. Most ACT contacts occur in community settings. ACT teams have a holistic approach to services, helping with medications, housing, finances and everyday problems in living. ACT differs conceptually and empirically from traditional case management approaches.
ACT is one of the best-researched mental health treatment models, with 25 randomized controlled trials evaluating its effectiveness. ACT substantially reduces psychiatric hospital use, increases housing stability, and moderately improves symptoms and subjective quality of life. In addition, ACT is highly successful in engaging patients in treatment. Research also suggests that the more closely case management programs follow ACT principles, the better the outcomes.
ACT services are costly. However, studies have shown the costs of ACT services to be offset by a reduction in hospital use in patients with a history of extensive hospital use.
The ACT model has been hugely influential in the mental health services field. ACT is significant because it offers a clearly defined model, and is clinically appealing to practitioners, financially appealing to administrators and scientifically appealing to researchers.
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References
Schinnar A, Rothbard A, Kanter R, et al. An empirical literature review of definitions of severe and persistent mental illness. Am J Psychiatry 1990; 147: 1602–8
Talbott JA, editor. The chronic mental patient. Washington, DC: American Psychiatric Association, 1978
Torrey EF. Surviving schizophrenia: a manual for families, consumers, and providers. 3rd ed. New York (NY): HarperCollins, 1995
Weiden PJ, Olfson M. The cost of relapse in schizophrenia. Schizophr Bull 1993; 21: 419–28
Turner JC, TenHoor WJ. The NIMH community support program: pilot approach to a needed social reform. Schizophr Bull 1978; 4: 319–48
Gold Award: community treatment program. Hosp Community Psychiatry 1974; 25: 669–72
Stein LI, Test MA, Marx AJ. Alternative to the hospital: a controlled study. Am J Psychiatry 1975; 132: 517–22
Stein LI, Test MA. An alternative to mental health treatment. I: Conceptual model, treatment program, and clinical evaluation. Arch Gen Psychiatry 1980; 37: 392–7
Stein LI, Test MA. The Training in Community Living model: a decade of experience. New Dir Ment Health Serv 1985; 26: 1–98
Solomon P. The efficacy of case management services for severely mentally disabled clients. Community Ment Health J 1992; 28: 163–80
Test MA, Stein LI. Practice guidelines for the community treatment of markedly impaired patients. Community Ment Health J 1976; 12: 72–82
McGrew JH, Bond GR. Critical ingredients of assertive community treatment: judgments of the experts. J Ment Health Adm 1995; 22: 113–25
Test MA. Training in community living. In: Liberman RP, editor. Handbook of psychiatric rehabilitation. New York (NY): MacMillan, 1992; 153–70
Witheridge TF. The ‘active ingredients’ of assertive outreach. New Dir Ment Health Serv 1991; 52: 47–64
Drake RE, Mercer-McFadden C, Mueser KT, et al. Treatment of substance abuse in patients with severe mental illness: a review of recent research. Schizophr Bull 1998; 24: 589–608
Bond GR. Principles of the Individual Placement and Support model: empirical support. Psychiatr Rehabil J 1998; 22(1): 11–23
Drake RE, Becker DR, Xie H, et al. Barriers in the brokered model of supported employment for persons with psychiatric disabilities. J Vocational Rehabil 1995; 5: 141–50
Rosenheck R, Morrissey J, Lam J, et al. Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness. Am J Public Health 1998; 88: 1610–5
Test MA. Continuity of care in community treatment. New Dir Ment Health Serv 1979; 2: 15–23
Ware NC, Tugenberg T, Dickey B, et al. An ethnographic study of the meaning of continuity of care in mental health services. Psychiatr Serv 1999; 50: 395–400
Bond GR, Pensec M, Dietzen L, et al. Intensive case management for frequent users of psychiatric hospitals in a large city: A comparison of team and individual caseloads. Psychosoc Rehabil J 1991; 15(1): 90–8
Boyer SL, Bond GR. Does assertive community treatment reduce burnout? A comparison with traditional case management. Mental Health Serv Res 1999; 1: 31–45
Salyers MR Predictors and consequences of staff burnout: a longitudinal study of assertive community treatment case managers [dissertation]. Indianapolis (IN): Indiana University-Purdue University Indianapolis, 1997
Ryan CS, Sherman PS, Bogart LM. Patterns of services and consumer outcome in an intensive case management program. J Consult Clin Psychol 1997; 65: 485–93
Salyers MP, Masterton TW, Fekete DM, et al. Transferring clients from intensive case management: impact on client functioning. Am J Orthopsychiatry 1998; 68: 233–45
Björkman T, Hansson L. What do case managers do? An investigation of case manager interventions and their relationship to client outcome. Soc Psychiatry Psychiatr Epidemiol 2000; 35: 43–50
Franklin JL, Solovitz B, Mason M, et al. An evaluation of case management. Am J Public Health 1987; 77: 674–8
King R, Le Bas J, Spooner D. The impact of caseload on the personal efficacy of mental health case managers. Psychiatr Serv 2000; 51: 364–8
Dilk MN, Bond GR. Meta-analytic evaluation of skills training research for individuals with severe mental illness. J Consult Clin Psychol 1996; 64: 1337–46
Stein LI. ’It’s the focus, not the locus.’ Hocus-pocus! [comment]. Hosp Community Psychiatry 1988; 39: 1029
Bond GR, Friedmeyer MH. Predictive validity of situational assessment at a psychiatric rehabilitation center. Rehabil Psychol 1987; 32: 99–112
McEvoy JP, Scheifler PL, Frances A. The expert consensus guideline series: treatment of schizophrenia 1999. J Clin Pyschiatry 1999; 60 Suppl. 11: 1–80
Miller AL, Chiles JA, Chiles JK, et al. Medication treatment for the severely and persistently mentally ill: the Texas Medication Algorithm Project. J Clin Pyschiatry 1999; 60: 649–57
McGrew JH, Wilson R, Bond GR. Client perspectives on helpful ingredients of assertive community treatment. Psychiatr Rehabil J 1996; 19(3): 13–21
Bond GR, Witheridge TF, Dincin J, et al. Assertive community treatment for frequent users of psychiatric hospitals in a large city: a controlled study. Am J Community Psychol 1990; 18: 865–91
Bond GR, Witheridge TF, Wasmer D, et al. A comparison of two crisis housing alternatives to psychiatric hospitalization. Hosp Community Psychiatry 1989; 40: 177–83
Test MA, Knoedler WH, Allness DJ. The long-term treatment of young schizophrenics in a community support program. New Dir Ment Health Serv 1985; 26: 17–27
McFarlane WR, Stastny P, Deakins S. Family-aided assertive community treatment: a comprehensive rehabilitation and intensive case management approach for persons with schizophrenic disorders. New Dir Ment Health Serv 1992; 53: 43–54
Russert MG, Frey JL. The PACT vocational model: A step into the future. Psychosocial Rehabil J 1991; 14(4): 7–18
Thornicroft G. The concept of case management for long-term mental illness. Int Rev Psychiatry 1991; 3: 125–32
Ellison ML, Rogers ES, Sciarappa K, et al. Characteristics of mental health case management: results of a national survey. J Ment Health Adm 1995; 22: 101–12
Essock SM, Kontos N. Implementing assertive community treatment teams. Hosp Community Psychiatry 1995; 46: 679–83
Teague GB, Drake RE, Ackerson TH. Evaluating use of continuous treatment teams for persons with mental illness and substance abuse. Psychiatr Serv 1995; 46: 689–95
Teague GB, Bond GR, Drake RE. Program fidelity in assertive community treatment: development and use of a measure. Am J Orthopsychiatry 1998; 68: 216–32
Schaedle R, Epstein I. Specifying intensive case management: a multiple stakeholder approach. Ment Health Serv Res 2000; 2: 95–105
Latimer E. Economic impacts of assertive community treatment: a review of the literature. Can J Psychiatry 1999; 44: 443–54
Witheridge TF, Dincin J, Appleby L. Working with the most frequent recidivists: a total team approach to assertive resource management. Psychosocial Rehabil J 1982; 5(1): 9–11
Marshall M, Creed F. Assertive community treatment: is it the future of community care in the UK? Int Rev Psychiatry 2000; 12: 191–6
Hadley TR, Turk R, McGurrin M. Community treatment teams: an alternative to state hospitals. Psychiatr Q 1997; 68: 77–90
Rothbard AB, Kuno E, Schinnar AP, et al. Service utilization and cost of community care for discharged state hospital patients: a 3-year follow-up study. Am J Psychiatry 1999; 156: 920–7
Marshall M. Designing psychiatric services to reduce hospital admissions. Clin Evidence 1999; 1: 63–70
Lehman AF, Dixon L, Hoch JS, et al. Cost-effectiveness of assertive community treatment for homeless persons with severe mental illness. Br J Psychiatry 1999; 174: 346–52
Morse GA, Calsyn RJ, Allen G, et al. Experimental comparison of the effects of three treatment programs for homeless mentally ill people. Hosp Community Psychiatry 1992; 43: 1005–10
Drake RE, McHugo GJ, Clark RE, et al. Assertive community treatment for patients with co-occurring severe mental illness and substance use disorder: a clinical trial. Am J Orthopsychiatry 1998; 68: 201–15
Draine J, Solomon P. Describing and evaluating jail diversion services for persons with serious mental illness. Psychiatr Serv 1999; 50: 56–61
Gold Award. Prevention of jail and hospital recidivism among persons with severe mental illness. Psychiatr Serv 1999; 50: 1477–80
Solomon P, Draine J. One-year outcomes of a randomized trial of case management with seriously mentally ill clients leaving jail. Eval Rev 1995; 19: 256–73
Steadman HJ, Deane MW, Morrissey JP, et al. A SAMHSA research initiative assessing the effectiveness of jail diversion programs for mentally ill persons. Psychiatr Serv 1999; 50: 1620–3
Latimer E, Conseil d’évaluation des technologies de la santé du Québec. Suivi intensif en équipe dans la communauté pour personnes atteintes de troubles mentaux graves. (CETS 99-1 RF). Montréal: Conseil d’évaluation des technologies (CETS); 1999
Greenley JR. Madison, Wisconsin, United States: creation and implementation of the Program of Assertive Community Treatment (PACT). In: Schulz R, Greenley JR, editors. Innovating in community mental health: international perspectives. Westport (CT): Praeger, 1995; 83–96
Marx AJ, Test MA, Stein LI. Extrohospital management of severe mental illness. Arch Gen Psychiatry 1973; 29: 505–11
Weisbrod BA, Test MA, Stein LI. Alternative to mental hospital treatment. II: Economic benefit-cost analysis. Arch Gen Psychiatry 1980; 37: 400–5
Dixon L. Assertive community treatment: twenty-five years of gold. Psychiatr Serv 2000; 51: 759–65
Deci PA, Santos AB, Hiott DW, et al. Dissemination of assertive community treatment teams. Psychiatr Serv 1995; 46: 676–8
Mowbray CT, Collins ME, Plum TB, et al. Harbinger I: the development and evaluation of the first PACT replication. Admin Policy Ment Health 1998; 25: 105–24
Mowbray CT, Plum TB, Masterton T. Harbinger II: deployment and evolution of assertive community treatment in Michigan. Admin Policy Ment Health 1998; 25: 125–39
Meisler N. Assertive community treatment initiatives: results from a survey of selected state mental health authorities. Community Support Network News 1997; 11(4): 3–5
Assertive Community Treatment Association, Inc [online]. Available from: URL: http://www.actassociation.com [Accessed 2001 Feb 17]
National Alliance for the Mentally Ill (NAMI). Treatment works: NAMI consumer and family guide to schizophrenia treatment. Alexandria (VA): NAMI, 1998
Furlong-Norman KE. Meeting review — states helping states: programs of assertive community treatment and managed care. Community Support Network News 1997; 11(4): 1–20
Flynn LM. Commentary. Schizophr Bull 1998; 24: 30–2
Thompson ST, Griffith EE, Leaf PJ. A historical review of the Madison model of community care. Hosp Community Psychiatry 1990; 41: 625–34
Bond GR. Variations in an assertive outreach model. New Dir Ment Health Serv 1991; 52: 65–80
Santos AB, Deci PA, Lachance KR, et al. Providing assertive community treatment for severely mentally ill patients in a rural area. Hosp Community Psychiatry 1993; 44: 34–9
Giesler LJ, Hodge M. Case management in behavioral health care. Int J Ment Health 1998; 27: 26–40
Sherman PS, Ryan CS. Intensity and duration of intensive case management services. Psychiatr Serv 1998; 49: 1585–9
Knapp MR, Marks IM, Wolstenholme J, et al. Home-based versus hospital-based care for serious mental illness: controlled cost-effectiveness study over four years. Br J Psychiatry 1998; 172: 506–12
Rosenthal RN, Hellerstein DJ, Miner CR. Stable patients tolerate step-down in targeted assertive outreach (TAO) services [abstract]. In: American Psychiatric Association Conference 2000; 2000 May 13–18; Chicago (IL), 215
Bond GR. Assertive community treatment as an evidence-based practice: critical ingredients, program implementation, and client outcomes. Annual Conference of the Indiana Division of Addiction and Mental Health Services; 2001 Feb 21–23; Indianapolis
Bond GR, Williams J, Evans L, et al. Psychiatric rehabilitation fidelity toolkit. Cambridge (MA): Human Services Research Institute, 2000
Harron B, Burns BJ, Swartz M. Hospital without walls [videotape]. Durham (NC): Duke University, 1993
Allness DJ, Knoedler WH. The PACT model of communitybased treatment for persons with severe and persistent mental illness: a manual for PACT start-up. Arlington (VA): National Alliance for the Mentally Ill, 1998
Stein LI, Santos AB. Assertive community treatment of persons with severe mental illness. New York (NY): W. W. Norton, 1998
Hoult J, Reynolds I, Charbonneau-Powis M, et al. Psychiatric hospital versus community treatment: the results of a randomised trial. AustN Z J Pyschiatry 1983; 17: 160–7
Cochrane J, Durbin J, Goering P. Best practices in mental health reform: discussion paper. Toronto (ON): Clarke Institute of Psychiatry, 1997
Lafave HG, deSouza HR, Gerber GJ. Assertive community treatment of severe mental illness: a Canadian experience. Psychiatr Serv 1996; 47: 757–9
Müller-Clemm W. Halting the ‘revolving door’ of serious mental illness: evaluating an assertive case management program [dissertation]. Victoria (BC): University of Victoria, 1996
Tyrer P. Whither community care? Br J Psychiatry 1998; 173: 359–60
Drake RE, Mueser KT, Torrey WC, et al. Evidence-based treatment of schizophrenia. Curr Psychiatry Rep 2000; 2: 393–7
Torrey WC, Wyzik PF. New Hampshire clinical practice guidelines for adults in community support programs. Lebanon (NH): West Central Services, 1997 Sep 1
Lehman AF, Steinwachs DM, PORT co-investigators. At issue: translating research into practice. The Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophr Bull 1998; 24: 1–10
Lehman AF, Steinwachs DM. Patterns of usual care for schizophrenia: initial results from the Schizophrenia Patient Outcomes Research Team (PORT) client survey. Schizophr Bull 1998; 24: 11–23
Manderscheid RW, Henderson MJ. Federal and state legislative and program directions for managed care. In: Mullen EJ, Magnabosco JL, editors. Outcome measurement in the human services: cross-cutting issues and methods. Washington, DC: National Association of Social Workers Press; 1997; 113–23
News & Notes. President Clinton announces an array of initiative at First White House Conference on Mental Health. Psychiatr Serv 1999; 50: 980–1
Commission on Accreditation of Rehabilitation Facilities. 2000 Behavioral standards manual. Tucson (AZ): CARF, the Rehabilitation Accreditation Commission, 2000
Quinlivan R. Managed care: cost savings and rehabilitation. Compatible goals in for-profit care for persons with serious mental illness? Psychiatr Serv 1997; 48: 1269–71
Talbott JA, Geller JL, Satel SL, et al. A roundtable discussion about the future of psychiatric services. Psychiatr Serv 2000; 51: 1513–6
Bond GR, Evans L, Salyers MP, et al. Measurement of fidelity in psychiatric rehabilitation. Ment Health Serv Res 2000; 2: 75–87
McGrew JH, Bond GR, Dietzen LL, et al. Measuring the fidelity of implementation of a mental health program model. J Consult Clin Psychol 1994; 62: 670–8
McHugo GJ, Drake RE, Teague GB, et al. The relationship between model fidelity and client outcomes in the New Hampshire Dual Disorders Study. Psychiatr Serv 1999; 50: 818–24
Johnsen M, Samberg L, Calsyn R, et al. Case management models for persons who are homeless and mentally ill: the ACCESS Demonstration Project. Community Ment Health J 1999; 35: 325–46
Winter JP, Calsyn RJ. The Dartmouth ACT Scale: a generalizability study. Eval Rev 2000; 24: 319–38
Clarke GN, Herinckx HA, Kinney RF, et al. Psychiatric hospitalizations, arrests, emergency room visits, and homelessness of clients with serious and persistent mental illness: findings from a randomized trial of two ACT programs vs. usual care. Ment Health Serv Res 2000; 2: 155–64
Bedell JR, Cohen NL, Sullivan A. Case management: the current best practices and the next generation of innovation. Community Ment Health J 2000; 36: 179–94
Baronet A, Gerber GJ. Psychiatric rehabilitation: efficacy of four models. Clin Psychol Rev 1998; 18: 189–228
Gorey KM, Leslie DR, Morris T, et al. Effectiveness of case management with severely and persistently mentally ill people. Community Ment Health J 1998; 34: 241–50
Herdelin AC, Scott DL. Experimental studies of the Program of Assertive Community Treatment (PACT): a meta-analysis. J Disabil Policy Stud 1999; 10: 53–89
Ziguras S, Stuart G. A meta-analysis of the effectiveness of mental health case management over 20 years. Psychiatr Serv 2000; 51: 1410–21
Mueser KT, Bond GR, Drake RE, et al. Models of community care for severe mental illness: a review of research on case management. Schizophr Bull 1998; 24: 37–74
Bond GR, Miller LD, Krumwied RD, et al. Assertive case management in three CMHCs: a controlled study. Hosp Community Psychiatry 1988; 39: 411–8
Bush CT, Langford MW, Rosen P, et al. Operation outreach: intensive case management for severely psychiatrically disabled adults. Hosp Community Psychiatry 1990; 41: 647–9
Chandler D, Meisel J, McGowen M, et al. Client outcomes in two model capitated integrated service agencies. Psychiatr Serv 1996; 47: 175–80
Fekete DM, Bond GR, McDonel EC, et al. Rural intensive case management: A controlled study. Psychiatr Rehabil J 1998; 21(4): 371–9
Godley SH, Hoewing-Roberson R, Godley MD. Final Mentally Ill Substance Abusers report: technical report. Bloomington (IL): Chestnut Health Systems, 1994
Hampton B, Korr W, Bond GR, et al. Integration service system approach to avert homelessness: CSP Homeless Prevention Project for HMI Adults. State of Illinois NIMH Demonstration Grant Program: final report. Chicago (IL): Illinois Department of Mental Health and Developmental Disabilities, 1992
Jerrell J, Hu T-W. Cost-effectiveness of intensive clinical and case management compared with an existing system of care. Inquiry 1989; 26: 224–34
Lehman AF, Dixon LB, Kernan E, et al. A randomized trial of assertive community treatment for homeless persons with severe mental illness. Arch Gen Psychiatry 1997; 54: 1038–43
Marks IM, Connolly J, Muijen M, et al. Home-based versus hospital-based care for people with serious mental illness. Br J Psychiatry 1994; 165: 179–94
Merson S, Tyrer P, Onyett S, et al. Early intervention in psychiatric emergencies: a controlled clinical trial. Lancet 1992; 339: 1311–4
Morse GA, Calsyn RJ, Klinkenberg WD, et al. An experimental comparison of three types of case management for homeless mentally ill persons. Psychiatr Serv 1997; 48: 497–503
Quinlivan R, Hough R, Crowell A, et al. Service utilization and costs of care for severely mentally ill clients in an intensive case management program. Psychiatr Serv 1995; 46: 365–71
Rosenheck R, Neale M, Leaf P, et al. Multisite experimental cost study of intensive psychiatric community care. Schizophr Bull 1995; 21: 129–40
Salkever D, Domino ME, Burns BJ, et al. Assertive community treatment for people with severe mental illness: the effect on hospital use and costs. Health Serv Res 1999; 34: 577–601
Bond GR, McGrew JH, Fekete DM. Assertive outreach for frequent users of psychiatric hospitals: a meta-analysis. J Ment Health Adm 1995; 22: 4–16
Rapp CA. The active ingredients of effective case management: a research synthesis. Community Ment Health J 1998; 34: 363–80
Curtis JL, Millman EJ, Struening E, et al. Effect of case management on rehospitalization and utilization of ambulatory care services. Hosp Community Psychiatry 1992; 43: 895–9
Gomory T. Coercion justified? Evaluating the Training in Community Living model: a conceptual and empirical critique [dissertation]. Berkeley (CA): University of California, 1998
Thornicroft G. Testing and retesting assertive community treatment. [editorial] Psychiatr Serv 2000; 51: 703
Weaver P. The PACT model: no one best practice. In: National Association of State Mental Health Program Directors Research Institute Conference; 2000 Feb 13–15; Washington, DC; 2000
McGrew JH, Wilson R, Bond GR. Client perspectives on dissatisfying elements of assertive community treatment: a preliminary report. In: Annual Meeting of the American Psychological Association; 1994 Aug 8–12; Los Angeles (CA)
Diamond RJ, Wilder DI. Ethical problems in community treatment of the chronically mentally ill. New Dir Ment Health Serv 1985; 26: 85–93
Neale MS, Rosenheck RA. Therapeutic limit setting in an assertive community treatment program. Psychiatr Serv 2000; 51: 499–505
Clark RE, Teague GB, Ricketts SK, et al. Cost-effectiveness of assertive community treatment versus standard case management for persons with co-occurring severe mental illness and substance use disorders. Health Serv Res 1998; 33: 1285–308
The Lewin Group. Systems analysis of evidence-based assertive community treatment: state profiles and site-visit protocols [prepared for Health Care Financing Administration, and Substance Abuse and Mental Health Services Administration]. Falls Church (VA): The Lewin Group, 2000
Borland A, McRae J, Lycan C. Outcomes of five years of continuous intensive case management. Hosp Community Psychiatry 1989; 40: 369–76
Chandler D, Hu TW, Meisel J, et al. Mental health costs, other public costs, and family burden among mental health clients in capitated integrated service agencies. J Ment Health Adm 1997; 24: 178–88
Knapp M, Beecham J, Koutsogeorgopouiou V, et al. Service use and costs of home-based versus hospital-based care for people with serious mental illness. BrJ Psychiatry 1994; 165: 195–203
Wolff N, Helminiak TW, Morse GA, et al. Cost-effectiveness evaluation of three approaches to case management for homeless mentally ill clients. Am J Psychiatry 1997; 154: 341–8
Wolff N, Helminiak TW. The anatomy of cost estimates — the ‘other’ outcome. In: Scheffler RM, Rossiter LF, editors. Advances in health economics and health services research. Greenwich (CT): JAI Press, 1993: 159–80
Hargreaves WA, Shumway M, Hu TW, et al. Cost-outcome methods for mental health. San Diego (CA): Academic Press, 1998
Essock SM, Frisman LK, Kontos NJ. Cost-effectiveness of assertive community treatment teams. Am J Orthopsychiatry 1998; 68: 179–90
Dincin J, Wasmer D, Witheridge TF, et al. Impact of assertive community treatment on the use of state hospital inpatient bed-days. Hosp Community Psychiatry 1993; 44: 833–8
Crane-Ross D, Roth D, Lauber BG. Consumers’ and case managers’ perceptions of mental health and community support service needs. Community Ment Health J 2000; 36: 161–78
Mueser KT, Goodman LB, Trumbetta SL, et al. Trauma and posttraumatic stress disorder in severe mental illness. J Consult Clin Psychol 1998; 66: 493–9
Weisbrod BA. A guide to benefit-cost analysis, as seen through a controlled experiment in treating the mentally ill. J Health Politics Policy Law 1983; 7: 808–46
Bond GR, Drake RE, Mueser KT, et al. An update on supported employment for people with severe mental illness. Psychiatr Serv 1997; 48: 335–46
Liberman RP, Kopelowicz A, Smith TE. Psychiatric rehabilitation. In: Kaplan BJ, Sadock VA, editors. Comprehensive textbook of psychiatry. 7th ed. Baltimore (MD): Williams & Wilkins, 1999: 3218–45
Mowbray CT, Moxley DP, Jasper CA, et al. Consumers as providers in psychiatric rehabilitation. Columbia (MD): International Association of Psychosocial Rehabilitation Services Publications, 1997
Chinman MJ, Rosenheck R, Lam JA, et al. Comparing consumer and nonconsumer provided case management services for homeless persons with serious mental illness. J Nerv Ment Dis 2000; 188: 446–53
Feiton CJ, Stastny P, Shern DL, et al. Consumers as peer specialists on intensive case management teams: impact on client outcomes. Psychiatr Serv 1995; 46: 1037–44
Lyons JS, Cook JA, Ruth AR, et al. Service delivery using consumer staff in a mobile crisis assessment program. Community Ment Health J 1996; 32: 33–40
Paulson R, Herinckx H, Demmler J, et al. Comparing practice patterns of consumer and non-consumer mental health service providers. Community Ment Health J 1999; 35: 251–69
Acknowledgements
Preparation of this review was supported by Grants 00839 and 00842 from the US National Institute of Mental Health. We thank Sandra Resnick for help in preparing the table.
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Bond, G.R., Drake, R.E., Mueser, K.T. et al. Assertive Community Treatment for People with Severe Mental Illness. Dis-Manage-Health-Outcomes 9, 141–159 (2001). https://doi.org/10.2165/00115677-200109030-00003
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DOI: https://doi.org/10.2165/00115677-200109030-00003