INTRODUCTIONAssertive Community Treatment (ACT) provides community-based treatment to patients with severe and persistent psychiatric illnesses, so that they may continue to live and function in the community as they receive psychiatric care. This study aimed to examine the effects of ACT on the outcome of patients over a 1-year period in an Asian population.

MATERIALS AND METHODSThis naturalistic and retrospective cohort study examined the effects of ACT on 100 patients who had completed 1 year of ACT. Parameters used to measure primary outcome were i) number of admissions (NOA) and ii) total length of stay (LOS) in days. Secondary outcome compared the employment status of patients before and after ACT. Paired sample analyses were performed using SPSS.

RESULTS AND DISCUSSIONThe mean reduction in NOA 1 year post-ACT was 57.1%. The mean reduction in LOS 1 year post-ACT was 61.9%. The median reduction for NOA and LOS were both statistically significant (P <0.01). Thirty-seven patients were employed compared to 6 before the programme, a statistically significant effect on employment (odds ratio 9.69, P <0.01).

CONCLUSIONSACT appears effective in reducing the frequency and duration of admissions for patients in Singapore. The employment status of patients also showed improvement over the course of study.

Adult ; Cohort Studies ; Community Mental Health Services ; methods ; standards ; Community Psychiatry ; standards ; Female ; Follow-Up Studies ; Humans ; Male ; Mental Disorders ; therapy ; Middle Aged ; Outcome Assessment (Health Care) ; methods ; Retrospective Studies ; Severity of Illness Index ; Singapore ; Social Adjustment

PURPOSE: The purpose of this study was to evaluate the service satisfaction for families who have someone with mental illness, and are using community mental health centers in Gyeonggi Province. METHODS: The participants in this study were 796 family members. Data were collected using Family satisfaction survey questionnaire developed by the author (23 items on family service and 15 items on client service). RESULTS: The total satisfaction level for the service with family and client resulted in above average scores. Of the 23 service items, data showed the highest level of satisfaction was with professional skills and attitude, and day rehabilitation programs, and the lowest for professional activities for advocacy and social welfare benefits, emergency & crisis intervention, medical expense subsidies. Of the 15 service items, job and housing related service had the lowest level of satisfaction. CONCLUSION: It is recommended that psychiatric emergency & crisis intervention programs and system development be accelerated. Also, there is a need to develop medical expense subsidy programs for older family caregivers, job and housing focused rehabilitation programs and community facilities for the client, as well as more active and powerful professional advocate activities for persons who have mental disabilities and their families.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Caregivers/economics/*psychology ; Community Mental Health Services/*standards ; Female ; Health Services Needs and Demand ; Humans ; Male ; Middle Aged ; *Personal Satisfaction ; Questionnaires