TY - JOUR
KW - assertive community treatment
KW - Community Mental Health Services
KW - Medical morbidity and mortality in psychiatric patients
KW - primary care
AU - E. R. Vanderlip
AU - B. F. Henwood
AU - D. R. Hrouda
AU - P. S. Meyer
AU - M. Monroe-Devita
AU - L. M. Studer
AU - A. J. Schweikhard
AU - L. L. Moser
A1 - 
AB - OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment. METHODS: Using a comprehensive list of relevant search terms, the authors performed a systematic literature database search for articles published through November 2015, resulting in ten articles for inclusion. RESULTS: No studies reported on clinical outcomes of general medical comorbidities or on mortality of ACT clients. Half of the studies reporting utilization (three of six) found a decrease in emergency room usage, and three of four studies identified an increase in outpatient primary care visits. Most studies found no increase in overall medical care costs. Of the few studies reporting on quality of life, most found mild to moderate improvements. CONCLUSIONS: To date, rigorous scientific examination of the effect of ACT on the general health of the populations it serves has not been undertaken. Given ACT's similarity to emerging chronic illness medical management models, the approach seems like a natural fit for improving general medical outcomes of persons with severe mental illnesses. More research is needed that investigates the current effect of ACT teams on general medical outcomes, treatment costs, and access to care.
BT - Psychiatric services (Washington, D.C.)
C5 - Healthcare Disparities
CP - 3
CY - United States
DO - 10.1176/appi.ps.201600100
IS - 3
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment. METHODS: Using a comprehensive list of relevant search terms, the authors performed a systematic literature database search for articles published through November 2015, resulting in ten articles for inclusion. RESULTS: No studies reported on clinical outcomes of general medical comorbidities or on mortality of ACT clients. Half of the studies reporting utilization (three of six) found a decrease in emergency room usage, and three of four studies identified an increase in outpatient primary care visits. Most studies found no increase in overall medical care costs. Of the few studies reporting on quality of life, most found mild to moderate improvements. CONCLUSIONS: To date, rigorous scientific examination of the effect of ACT on the general health of the populations it serves has not been undertaken. Given ACT's similarity to emerging chronic illness medical management models, the approach seems like a natural fit for improving general medical outcomes of persons with severe mental illnesses. More research is needed that investigates the current effect of ACT teams on general medical outcomes, treatment costs, and access to care.
PP - United States
PY - 2017
SN - 1557-9700; 1075-2730
SP - 218
EP - 224
EP - 
T1 - Systematic Literature Review of General Health Care Interventions Within Programs of Assertive Community Treatment
T2 - Psychiatric services (Washington, D.C.)
TI - Systematic Literature Review of General Health Care Interventions Within Programs of Assertive Community Treatment
U1 - Healthcare Disparities
U2 - 27903142
U3 - 10.1176/appi.ps.201600100
VL - 68
VO - 1557-9700; 1075-2730
Y1 - 2017
ER -