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Assertive community treatment

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https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#1
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
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...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27900751/-reflection-on-the-differences-and-similarities-of-mental-health-care-in-virginia-and-taiwan-geography-history-culture-and-nurse-practitioners
#2
Chueh-Fen Lu, Ching-Chuan Tung, Linda Ely
Sponsored by the pilot overseas internships project of the Ministry of Education, Taiwan, the authors and ten undergraduate students from Taiwan visited several mental health facilities in Virginia for one month. These facilities included the Catawba State Hospital, Salem Veteran Affairs Medical Center, Carilion Saint Albans Behavioral Health (New River Valley Medical Center), Warm Hearth Village, Adult & Child Family Counseling private outpatient clinic, the Free Clinic of the New River Valley, New Life Clubhouse, and Self-Government Program for Assertive Community Treatment...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27888961/facilitating-social-integration-for-people-with-severe-mental-illness-served-by-assertive-community-treatment
#3
Sheila J Linz, Bonnie A Sturm
PURPOSE: This article explores the experience of workers on Assertive Community Treatment (ACT) teams surrounding their efforts to facilitate social integration for their clients. DESIGN AND METHODS: Sixteen workers were individually interviewed and eight additional workers participated in two focus groups. FINDINGS: The formation of caring relationships between worker and client was an important first step towards social integration for ACT clients...
December 2016: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/27783548/patterns-of-adherence-to-oral-atypical-antipsychotics-among-patients-diagnosed-with-schizophrenia
#4
Joanna P MacEwan, Felicia M Forma, Jason Shafrin, Ainslie Hatch, Darius N Lakdawalla, Jean-Pierre Lindenmayer
BACKGROUND: Poor medication adherence contributes to negative treatment response, symptom relapse, and hospitalizations in schizophrenia. Many health plans use claims-based measures like medication possession ratios or proportion of days covered (PDC) to measure patient adherence to antipsychotics. Classifying patients solely on the basis of a single average PDC measure, however, may mask clinically meaningful variations over time in how patients arrive at an average PDC level. OBJECTIVE: To model patterns of medication adherence evolving over time for patients with schizophrenia who initiated treatment with an oral atypical antipsychotic and, based on these patterns, to identify groups of patients with different adherence behaviors...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27736146/the-effect-of-therapists-adherence-and-competence-in-delivering-the-adolescent-community-reinforcement-approach-on-client-outcomes
#5
Marita Campos-Melady, Jane Ellen Smith, Robert J Meyers, Susan H Godley, Mark D Godley
Central to the debate over the implementation of empirically supported treatments is whether therapist skill has a measurable, positive relationship with client outcome. The fidelity and skill with which therapists deliver treatments have been studied under the constructs of adherence and competence. Evidence for a relationship between adherence and competence and client outcomes has been mixed, possibly due to small sample sizes, potentially inadequate measures for rating therapists' skill, and limited statistical methods...
October 13, 2016: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/27734712/a-qualitative-study-of-occupational-well-being-for-people-with-severe-mental-illness
#6
Benjamin Milbourn, Beverley McNamara, Angus Buchanan
BACKGROUND/AIM: People with severe mental illness (SMI) do not receive adequate attention in research or clinical practice. They are considered hard to reach and difficult to engage. Information is needed to help provide support for this vulnerable population. This paper aims to investigate the well-being of adults diagnosed with SMI and receiving Assertive Community Treatment (ACT) by applying the occupational well-being framework to the everyday activities of this vulnerable group of people...
October 13, 2016: Scandinavian Journal of Occupational Therapy
https://www.readbyqxmd.com/read/27716190/-i-go-i-die-i-stay-i-die-better-to-stay-and-die-in-my-house-understanding-the-barriers-to-accessing-health-care-in-timor-leste
#7
Jennifer A Price, Ana I F Sousa Soares, Augustine D Asante, Joao S Martins, Kate Williams, Virginia L Wiseman
BACKGROUND: Despite public health care being free at the point of delivery in Timor-Leste, wealthier patients access hospital care at nearly twice the rate of poorer patients. This study seeks to understand the barriers driving inequitable utilisation of hospital services in Timor-Leste from the perspective of community members and health care managers. METHODS: This multisite qualitative study in Timor-Leste conducted gender segregated focus groups (n = 8) in eight districts, with 59 adults in urban and rural settings, and in-depth interviews (n = 8) with the Director of community health centres...
September 30, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27681009/-housing-first-for-homeless-youth-with-mental-illness
#8
Nicole Kozloff, Carol E Adair, Luis I Palma Lazgare, Daniel Poremski, Amy H Cheung, Rebeca Sandu, Vicky Stergiopoulos
BACKGROUND AND OBJECTIVES: "Housing First" has been shown to improve housing stability in homeless individuals with mental illness, but had not been empirically tested in homeless youth. We aimed to evaluate the effect of "Housing First" on housing stability in homeless youth aged 18 to 24 years participating in At Home/Chez Soi, a 24-month randomized trial of "Housing First" in 5 Canadian cities. METHODS: Homeless individuals with mental illness were randomized to receive "Housing First" (combined with assertive community treatment or intensive case management depending on their level of need) or treatment as usual...
September 28, 2016: Pediatrics
https://www.readbyqxmd.com/read/27665002/housing-first-improves-adherence-to-antipsychotic-medication-among-formerly-homeless-adults-with-schizophrenia-results-of-a-randomized-controlled-trial
#9
Stefanie N Rezansoff, Akm Moniruzzaman, Seena Fazel, Lawrence McCandless, Ric Procyshyn, Julian M Somers
Adherence to antipsychotic medication is a significant challenge among homeless patients. No experimental trials have investigated the impact of Housing First on adherence among patients with schizophrenia. We investigated whether Housing First in congregate and scattered-site configurations resulted in superior adherence compared to usual care. Adult participants (n = 165) met criteria for homelessness, schizophrenia, and initiation of antipsychotic pharmacotherapy prior to recruitment to an unblinded, 3-arm randomized controlled trial in Vancouver, Canada...
September 24, 2016: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/27662458/prevalence-of-vitamin-d-deficiency-in-adult-outpatients-with-bipolar-disorder-or-schizophrenia
#10
Remco Boerman, Dan Cohen, Peter F J Schulte, Annet Nugter
OBJECTIVE: Several studies show an association between schizophrenia and low levels of vitamin D. To date, there are only few studies about the prevalence of vitamin D deficiency in patients with bipolar disorder. We hypothesized that vitamin D deficiency is less common among patients with bipolar disorder than among patients with schizophrenia or schizoaffective disorder. A second hypothesis is that vitamin D deficiency is more prevalent among patients with schizophrenia, schizoaffective disorder, or bipolar disorders than among the general Dutch population...
December 2016: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27658371/narrative-exposure-therapy-for-posttraumatic-stress-disorder-associated-with-repeated-interpersonal-trauma-in-patients-with-severe-mental-illness-a-mixed-methods-design
#11
Maria W Mauritz, Betsie G I Van Gaal, Ruud A Jongedijk, Lisette Schoonhoven, Maria W G Nijhuis-van der Sanden, Peter J J Goossens
BACKGROUND: In the Netherlands, most patients with severe mental illness (SMI) receive flexible assertive community treatment (FACT) provided by multidisciplinary community mental health teams. SMI patients with comorbid posttraumatic stress disorder (PTSD) are sometimes offered evidence-based trauma-focused treatment like eye movement desensitization reprocessing or prolonged exposure. There is a large amount of evidence for the effectiveness of narrative exposure therapy (NET) within various vulnerable patient groups with repeated interpersonal trauma...
2016: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/27636364/-treatment-at-home-in-lengerich-westfalia-a-model-of-community-based-mental-health-care
#12
E Sakellaridou, C Chrysanthou, A Nienaber
We examined the effectiveness of a new homebased integrated care intervention model for patients with multiple-episode psychosis in a rural area in Germany, which combines elements of 2 other well-defined interventions: Assertive Community Treatment and Home Treatment. The pilot evaluation was conducted in 2 steps, using a quantitative and a qualitative design. In a 24-month follow-up period, patients showed significant improvement in symptoms, illness severity, global functioning and quality of life, as well as larger reduction in the number of days of inpatient treatment needed...
September 16, 2016: Das Gesundheitswesen
https://www.readbyqxmd.com/read/27619826/how-did-a-housing-first-intervention-improve-health-and-social-outcomes-among-homeless-adults-with-mental-illness-in-toronto-two-year-outcomes-from-a-randomised-trial
#13
Patricia O'Campo, Vicky Stergiopoulos, Pam Nir, Matthew Levy, Vachan Misir, Antony Chum, Bouchra Arbach, Rosane Nisenbaum, Matthew J To, Stephen W Hwang
OBJECTIVES: We studied the impact of a Housing First (HF) intervention on housing, contact with the justice system, healthcare usage and health outcomes among At Home/Chez Soi randomised trial participants in Toronto, a city with an extensive service network for social and health services for individuals who are experiencing homelessness and mental illness. METHODS: Participants identified as high needs were randomised to receive either the intervention which provided them with housing and supports by an assertive community treatment team (HF+ACT) or treatment as usual (TAU)...
September 12, 2016: BMJ Open
https://www.readbyqxmd.com/read/27618789/early-detection-and-integrated-care-for-adolescents-and-young-adults-with-severe-psychotic-disorders-rationales-and-design-of-the-integrated-care-in-early-psychosis-study-access-iii
#14
Martin Lambert, Daniel Schöttle, Mary Sengutta, Friederike Ruppelt, Anja Rohenkohl, Daniel Luedecke, Luise Antonia Nawara, Britta Galling, Anne-Lena Falk, Linus Wittmann, Vivien Niehaus, Gizem Sarikaya, Ute Handwerk, Wiebke Rothländer, Liz Rietschel, Charlotte Gagern, Benjamin Lange, Christina Meigel-Schleiff, Dieter Naber, Michael Schulte-Markwort, Helmut Krüger, Hans-Peter Unger, Sven Sippel, Sabine Ott, Georg Romer, Anne Daubmann, Karl Wegscheider, Christoph U Correll, Benno G Schimmelmann, Thomas Bock, Jürgen Gallinat, Anne Karow
AIM: The Integrated Care in Early Psychosis (ACCESS III) Study examined the efficacy and cost-effectiveness of a combined intervention consisting of strategies to improve early detection and quality of care (integrated care including therapeutic assertive community treatment) in adolescents and young adults in the early phase of a severe psychotic disorder from 2011 to 2014. METHODS: This is a prospective, single-centre, 1-year cohort study comparing an intervention condition (early detection plus integrated care, n = 120) to the historical control condition (standard care, SC, n = 105) for adolescents and young adults aged 12-29 years suffering from a severe, early-phase psychotic disorder (i...
September 12, 2016: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/27614380/remission-from-substance-use-disorders-a-systematic-review-and-meta-analysis
#15
REVIEW
M-J Fleury, Akram Djouini, Christophe Huỳnh, Joël Tremblay, Francine Ferland, J-M Ménard, Geneviève Belleville
OBJECTIVE: This paper presents a systematic review and meta-analysis of available evidence on remission rates for substance use disorders (SUDs), providing weighted mean estimates of SUD remission rates. The review also explores study-level characteristics that may explain variations in remission rates across studies. METHODS: A comprehensive search strategy identified studies published between 2000 and 2015 with follow-up periods of at least three years or reported lifetime remission outcomes for potential inclusion in the review...
November 1, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27599432/assertive-community-treatment-and-associations-with-delinquency
#16
Maaike D van Vugt, Hans Kroon, Philippe A E G Delespaul, Cornelis L Mulder
This article draws on a prospective longitudinal study in which Assertive Community Treatment (ACT) model fidelity and patient outcomes were assessed in twenty outpatient treatment teams. 530 severely mentally ill patients participated in the study. Delinquency outcomes were assessed three times during a two-year follow-up period. At baseline, 49% of the patients had a recent criminal history, meaning that they had at least one reported contact with the police and/or the justice system in the past year. Patients with a recent criminal history had more serious psychosocial problems at baseline compared to those without a recent criminal history...
September 2016: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/27490832/longitudinal-assessment-of-clinical-risk-factors-for-depression-in-schizophrenia-spectrum-disorders
#17
Obiora E Onwuameze, Aghaegbulam Uga, Sergio Paradiso
BACKGROUND: During initial assessment of individuals with schizophrenia and related disorders (schizophrenia spectrum disorders [SSDs]), clinicians tend to pay greater attention to psychotic symptoms than mood symptoms, including depression. Depression is reported to influence the course of SSDs, but not much is known about the risk factors for depression in SSDs. In the present study, we examined clinical predictors of depression in SSDs. METHODS: The sample included 71 patients with SSDs followed in a modified Assertive Community Treatment program, the Community Support Network of Springfield, Illinois...
August 2016: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/27461844/mental-health-professional-experiences-of-the-flexible-assertive-community-treatment-model-a-grounded-theory-study
#18
Annika Lexén, Bengt Svensson
BACKGROUND: Despite the lack of evidence for effectiveness of the Flexible Assertive Community Treatment (Flexible ACT), the model is considered feasible and is well received by mental health professionals. No current studies have adequately examined mental health professional experiences of working with Flexible ACT. AIMS: The aim of this study was to explore mental health professional experiences of working with the Flexible ACT model compared with standard care...
July 27, 2016: Journal of Mental Health
https://www.readbyqxmd.com/read/27451516/-assertive-community-treatment-promoting-engagement-with-care-of-people-suffering-severe-addiction
#19
Stéphane Morandi, Benedetta Silva, Martine Monnat, Charles Bonsack
Despite the increasing number of specialized addiction services and the constant deployment of health care resources, a coordinated needs-based treatment is not always available for people with severe drugs and/or alcohol problems. Too often the involved health care professionals feel helpless and overwhelmed by the complexity of the situation. In order to promote the treatment engagement of the hard-to-reach substance users, a multidisciplinary mobile team project for addiction (SIMA) was developed in Lausanne, Switzerland, in 20174...
June 8, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/27422650/forensic-assertive-community-treatment-a-review-of-the-literature
#20
Thomas Marquant, Bernard Sabbe, Meike Van Nuffel, Kris Goethals
An extensive body of literature provides evidence supporting the effectiveness of assertive community treatment (ACT) with regard to non-forensic outcome measures, such as number of hospital admissions and length of stay. However, research findings on the effectiveness of ACT for forensic outcome measures, such as rearrests or detentions, is much less clear. The present review, therefore, focuses on the application of ACT in forensic populations, combining key elements of ACT with elements of forensic rehabilitation models...
July 15, 2016: Community Mental Health Journal
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