ArticleSocial psychiatry and psychiatric epidemiology2013
A dismantling study of assertive outreach services: comparing activity and outcomes following replacement with the FACT model.
Article in Social psychiatry and psychiatric epidemiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed.
- Assertive Community Treatment and ACT-Derived Outreach Models: A Scoping Review of Adaptations, Fidelity and Outcomes.Community mental health journal · 2026Article
- What is known about flexible assertive community treatment across populations and contexts? A scoping review protocol.BMJ open · 2025Article
- Changes in inpatient mental health treatment and related costs before and after flexible assertive community treatment: a naturalistic observational cohort study.BMC psychiatry · 2025Observational
- Implementing the flexible ACT model in an Italian residential facilities multidisciplinary team.The International journal of social psychiatry · 2024Article
- Exploring New Models for Implementing Sustainable Integrated Health Access for People in Vulnerable Positions: Protocol for a Mixed Methods Multiple Case Study.JMIR research protocols · 2024Article
- Evaluation of a flexible assertive community treatment (FACT) program for patients with severe mental illness: an observational study in Salzburg, Austria.International journal of mental health systems · 2024Article
- Current insights of community mental healthcare for people with severe mental illness: A scoping review.Frontiers in psychiatry · 2023Article
- Observational
- Recovery for all in the community; position paper on principles and key elements of community-based mental health care.BMC psychiatry · 2019Article
- The resource group method in severe mental illness: study protocol for a randomized controlled trial and a qualitative multiple case study.International journal of mental health systems · 2019Article
- Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre.BMC psychiatry · 2018Article
- Flexible assertive community treatment (FACT) model in specialist psychosis teams: an evaluation.BJPsych bulletin · 2017Article
- Outcomes of FLEXIBLE Assertive Community Treatment (FACT) Implementation: A Prospective Real Life Study.Community mental health journal · 2016Article
- The Hourglass Model: Are There Structural Problems with the Scarcity of Positive Results for Flexible ACT?Clinical practice and epidemiology in mental health : CP & EMH · 2015Article
- Flexible ACT & Resource-group ACT: Different Working Procedures Which Can Supplement and Strengthen Each Other. A Response.Clinical practice and epidemiology in mental health : CP & EMH · 2015Article
- Community outreach for patients who have difficulties in maintaining contact with mental health services: longitudinal retrospective study of the Japanese outreach model project.BMC psychiatry · 2014Article
- Absence of Positive Results for Flexible Assertive Community Treatment. What is the next Approach?Clinical practice and epidemiology in mental health : CP & EMH · 2014Article
- Flexible Assertive Community Treatment, Severity of Symptoms and Psychiatric Health Service Use, a Real life Observational Study.Clinical practice and epidemiology in mental health : CP & EMH · 2013Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFinancial constraints and some disappointing research evaluations have seen English assertive outreach (AO) teams subject to remodelling, decommissioning and integration into standard care. We tested a specific alternative model of integrating the AO function from two AO teams into six standard community mental health teams (CMHT). The Flexible Assertive Community Treatment model (FACT) was adopted from the Netherlands (Van Veldhuizen, Commun Mental Health J 43(4):421-433, 2007; Bond and Drake, Commun Mental Health J 43(4):435-438, 2007). We aimed to demonstrate non-inferiority in clinical effectiveness and thereby show cost efficiencies associated with FACT.
methodsOutcomes were compared in a mirror-image study of the 12 months periods pre- and post-service change with eligible individuals from the AO teams' caseloads (n = 112) acting as their own controls. We also conducted a cost-consequence analysis of the changes. Outcome data regarding admissions, use of crisis and home treatment, frequency of contact and DNA rate were extracted from the electronic patient record.
resultsThe results show AO patients (n = 112) transferred to standard CMHTs with FACT had significantly fewer admissions and a halving of bed use (21 fewer admission and 2,394 fewer occupied bed days) whilst being in receipt of a less intensive service (2,979 fewer contacts). This was offset by significantly poorer engagement but not by increased use of crisis and home treatment services.
conclusionsEnhancing multi-disciplinary CMHTs with FACT provides a clinically effective alternative to AO teams. FACT offers a cost-effective model compared to AO.
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