SynthesisFrontiers in psychiatry2026
Assertive community treatment for adults with complex mental illness and emergency department use: a systematic review.
Synthesis in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Emergency Department (ED) wait times have increased globally, resulting in treatment delays and system strain. Complex mental health consumers, those with Serious and Persistent Mental Illness (SPMI), are a consistent subgroup of ED presenters. Assertive Community Treatment (ACT) has shown promise in reducing inpatient demand but has been criticized as cost-intensive with limited rehabilitation outcomes. This systematic review evaluated ACT's effectiveness in reducing ED usage and improving psychosocial outcomes. Methods: Nine databases were searched (31/12/2013-25/10/2023), yielding studies with moderate Risk of Bias scores. Studies spanned urban and rural areas across diverse geographic regions (Asia Pacific, Europe, North America). Results: ACT was associated with reductions in ED presentations and costs in seven studies. Improvements in psychosocial functioning were documented in five studies, although symptom reduction was limited. These findings were primarily based on clinician-reported Routine Outcome Measures (ROMs), with minimal inclusion of patient-reported outcomes, limiting interpretive reliability. Discussion: The evidence suggests that ACT programs reduce the incidence of, and costs associated with ED use and improve patient wellbeing (particularly social functioning) in participants with SPMI. The absence of comparisons between ED savings and ACT implementation costs restricts conclusions about sustainability. These results are limited in generalizability due to a moderate risk of bias related to confounding variables. Future research should explore client perspectives and cost-benefit analyses. In the interim, ACT may be an appropriate intervention for clients with SMPI and high ED usage who are unable to be managed via case management teams. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023474465, identifier CRD42023474465.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.