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Assertive community treatment for homeless adults with severe mental illnesses was effective but not more expensive than usual care

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Question In homeless people with severe mental illnesses, is assertive community treatment (ACT) cost effective for increasing time spent in stable community housing?


Economic analysis of a randomised controlled trial with 12 months follow up.


Baltimore, Maryland, USA.


152 adults (mean age 37 y, 67% men, 72% African-American) who were homeless and had severe mental illnesses (58% schizophrenia or schizoaffective disorder, 20% bipolar disorder, 8% major depression, 14% other severe mental illnesses). {Follow up at 12 months was 83%.}*


Adults were allocated to ACT {n=77}* or usual care {n=75}*. The goal of ACT was to promote continuity of care; a team of multidisciplinary professionals was available 24 hours/day, and they sought to integrate assertive, community based, clinical treatment with intensive case management and advocacy. Usual care consisted of services …

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