Long-term outcomes of an assertive community treatment (ACT) intervention : a 10-year follow-up

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Stellenbosch : Stellenbosch University
ENGLISH SUMMARY: Background: Assertive community treatment (ACT) is an intervention implemented in many countries to manage the effects of deinstitutionalization, with studies in South Africa demonstrating decreased admissions at 12 and 36-month follow-up for patients receiving modified ACT compared to standard care. Whilst shown to be effective, costs associated with the intervention has raised the question of its feasibility in developing countries. Aim: This study aimed to describe the demographic and clinical outcomes of a group of patients included in an ACT interventional study, 10 years after inclusion. Methods: This is a retrospective description of the 10-year outcomes of a group of 55 highfrequency psychiatric users (HFUs) included in the first ACT intervention in South Africa. The group either received follow-up with a modified ACT program or at a community care centre. Demographics, admissions, social functioning and adverse events were outcomes reviewed. Results: Nine patients remained in ACT for the full 10 years, 16 were never included and 30 patients spent some time in ACT. Five participants died, 2 were admitted to long-term wards and 12 were never re-admitted. The group had an overall low level of education, a mean age of 43 years and most were single (82%). The mean number of admissions were 3.73 and the mean number of admission days was 261.11. Conclusions: This was the first study looking at the long-term outcomes of a group of HFUs in an under-resourced setting receiving a modified ACT intervention. Correlation with the poor psychosocial outcomes often associated with schizophrenia were found in this group, but overall, the study findings suggest increased stabilization, service utilization and quality of life for patients exposed to ACT at some stage in their treatment.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Thesis (MMed)--Stellenbosch University, 2022.
Community mental health services -- Cape Town (South Africa), Mentally ill -- Services for -- Cape Town (South Africa), Mental health services -- Cape Town (South Africa), UCTD