The rise of assertive community interventions in South Africa : a randomized control trial assessing the impact of a modified assertive intervention on readmission rates; a three year follow-up

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dc.contributor.authorBotha, Ulla A.
dc.contributor.authorKoen, Liezl
dc.contributor.authorGalal, Ushma
dc.contributor.authorJordaan, Esme
dc.contributor.authorNiehaus, Daniel J. H.
dc.date.accessioned2014-04-14T07:48:48Z
dc.date.available2014-04-14T07:48:48Z
dc.date.issued2014-02
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.en_ZA
dc.descriptionCITATION: Botha, U. A. et al. 2014. The rise of assertive community interventions in South Africa: a randomized control trial assessing the impact of a modified assertive intervention on readmission rates; a three year follow-up. BMC Psychiatry, 14:56, doi:10.1186/1471-244X-14-56.en_ZA
dc.descriptionThe original publication is available at http://www.biomedcentral.com/bmcpsychiatry/en_ZA
dc.description.abstractBackground: Many countries have over the last few years incorporated mental health assertive interventions in an attempt to address the repercussions of deinstitutionalization. Recent publications have failed to duplicate the positive outcomes reported initially which has cast doubt on the future of these interventions. We previously reported on 29 patients from a developing country who completed 12 months in an assertive intervention which was a modified version of the international assertive community treatment model. We demonstrated reduction in readmission rates as well as improvements in social functioning compared to patients from the control group. The obvious question was, however, if these outcomes could be sustained for longer periods of time. This study aims to determine if modified assertive interventions in an under-resourced setting can successfully maintain reductions in hospitalizations. Methods: Patients suffering from schizophrenia who met a modified version of Weidens’ high frequency criteria were randomized into two groups. One group received a modified assertive intervention based on the international assertive community treatment model. The other group received standard care according to the model of service delivery in this region. Data was collected after 36 months, comparing readmissions and days spent in hospital. Results: The results demonstrated significant differences between the groups. Patients in the intervention group had significantly less readmissions (p = 0.007) and spent less days in hospital compared to the patients in the control group (p = 0.013). Conclusion: Modified assertive interventions may be successful in reducing readmissions and days spent in hospital in developing countries where standard care services are less comprehensive. These interventions can be tailored in such a way to meet service needs and still remain affordable and feasible within the context of an under-resourced setting.en_ZA
dc.description.sponsorshipStellenbosch Universityen_ZA
dc.description.versionPublishers' Versionen_ZA
dc.format.extent10 p. ; ill.
dc.identifier.citationBotha, U.A. et al. 2014. The rise of assertive community interventions in South Africa: a randomized control trial assessing the impact of a modified assertive intervention on readmission rates; a three year follow-up. BMC Psychiatry, 14:56, doi:10.1186/1471-244X-14-56.en_ZA
dc.identifier.issn1471-244X (print)
dc.identifier.issn1471-244X (online)
dc.identifier.otherdoi:10.1186/1471-244X-14-56
dc.identifier.urihttp://hdl.handle.net/10019.1/86170
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectCommunity mental health services -- South Africa -- Cape Townen_ZA
dc.subjectMental illness -- Treatment -- South Africa -- Cape Townen_ZA
dc.subjectPsychiatric hospitals -- Outpatient services -- South Africa -- Cape Townen_ZA
dc.subjectHospital utilization -- Length of stay -- South Africa -- Cape Townen_ZA
dc.subjectMental health facilities -- Admission and discharge -- South Africa -- Cape Townen_ZA
dc.titleThe rise of assertive community interventions in South Africa : a randomized control trial assessing the impact of a modified assertive intervention on readmission rates; a three year follow-upen_ZA
dc.typeArticleen_ZA
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