OBJECTIVE: This study examined outcomes of clients admitted to assertive
community treatment programs simultaneously implemented at six sites in
northeastern Indiana. METHODS: A total of 212 clients at risk for
psychiatric rehospitalization were assessed at baseline and at six-month
intervals for 18 months after admission to assertive community treatment
programs. Data on rehospitalization, quality of life, and level of
functioning were compared using t tests. Progressive improvement was also
examined by linear trend analysis. RESULTS: Frequency of psychiatric
hospitalization was reduced by one-third and the number of inpatient days
by 50 percent after admission to the program. Improvements were
progressive, with continued reductions over the 18-month period.
Progressive improvements also occurred in quality of life as measured by
both client and staff ratings. Case managers rated clients as having
improved family and social support, increased self-reliance and
independence, and improved daily living skills. Clients reported
significantly more legal problems, which may have been an artifact of
increased monitoring during treatment. A key element of the programs'
success was the position of clinical coordinator, important functions of
which are described. CONCLUSIONS: Results of this study provide support for
wide-scale dissemination of assertive community treatment as an effective
form of community care for persons with serious mental illness.