The purpose of this paper is to describe an Adult Community Treatment (ACT) program in Dandenong, Victoria, and its effect upon admission rates and time in hospital for 50 of the serviceapos;s most disturbed patients. The implementation of the program was associated with a reduction in the annual re-admission rate from 38% (1989–90) to 21% (1990–91); the total length of hospital stay was also significantly reduced. The results support the value of community support programs in the management of the seriously mentally ill.
References
1.
AnthonyWBuellGJSaraS.The efficacy of psychiatric rehabilitation. Psychological Bulletin1972; 78:447–456.
2.
AnthonyWCohenMVitaloR.The measurement of rehabilitation outcome. Schizophrenia Bulletin1973; 4:365–383.
3.
BachrachL.A note on some recent studies of released mental hospital patients in the community. American Journal of Psychiatry1976; 133:73–75.
4.
BraffJLefkowitzM.Community mental health treatment: What works for whom?Psychiatry Quarterly1989; 51:119–134.
5.
SolomonPDollW.The varieties of readmission: the case against the use of recidivism rates as a measure of program effectiveness. American Journal of Orthopsychiatry1979; 49:230–239.
6.
KirkS.Effectiveness of community services for discharged mental hospital patients. American Journal of Orthopsychiatry1976; 46:646–659.
7.
MinkoffK.A map of chronic mental patients. In: TalbottJ, ed. The chronic mental patient. Washington DC, American Psychiatric Association, 1978.
8.
HoultJReynoldsICharbonneau-PowisM.Psychiatric hospital versus community treatment: The results of a randomised trial. Australian and New Zealand Journal of Psychiatry1983; 17:160–167.
9.
HoultJ.Schizophrenia: A comparative trial of community orientated and hospital orientated psychiatric care. Acta Psychiatrica Scandinavica1984; 69:359–372.
10.
HoultJ.Community orientated treatment compared to psychiatric hospital orientated treatment. Social Science and Medicine1984; 18:1005–1010.
11.
HoultJ.Community care of the acutely mentally ill. British Journal of Psychiatry1986; 149:137–144.
12.
BondGRMillerLDKrumweidRD.Assertive case management in three CMHCs: A controlled study. Hospital and Community Psychiatry1988; 39:411–418.
13.
WinstonA.Aftercare of psychiatric patients and its relation to rehospitalization. Hospital and Community Psychiatry1977; 28:118–121.
14.
BachrachLLLambR.What have we learned from deinstitutionalization?Psychiatric Annals1989; 19:12–21.
15.
SteinLI.Funding a system of care for schizophrenia. Psychiatric Annals1987; 17:592–598.
16.
DegenKColeNTamayoLDzerovychK.Intensive case management for the seriously mentally ill. Administration and Policy in Mental Health1990; 17:265–269.
