The effect of youth assertive community treatment: a systematic PRISMA review
Abstract Background During the past decades deinstitutionalisation policies have led to a transition from inpatient towards community mental health care. Many European countries implement Assertive Community Treatment (ACT) as an alternative for inpatient care for “difficult to reach” children and a...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12888-017-1446-4 |
| _version_ | 1831602278185828352 |
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| author | Richard Vijverberg Robert Ferdinand Aartjan Beekman Berno van Meijel |
| author_facet | Richard Vijverberg Robert Ferdinand Aartjan Beekman Berno van Meijel |
| author_sort | Richard Vijverberg |
| collection | DOAJ |
| description | Abstract Background During the past decades deinstitutionalisation policies have led to a transition from inpatient towards community mental health care. Many European countries implement Assertive Community Treatment (ACT) as an alternative for inpatient care for “difficult to reach” children and adolescents with severe mental illness. ACT is a well-organized low-threshold treatment modality; patients are actively approached in their own environment, and efforts are undertaken to strengthen the patient’s motivation for treatment. The assumption is that ACT may help to avoid psychiatric hospital admissions, enhance cost-effectiveness, stimulate social participation and support, and reduce stigma. ACT has been extensively investigated in adults with severe mental illness and various reviews support its effectiveness in this patient group. However, to date there is no review available regarding the effectiveness of youth-ACT. It is unknown whether youth-ACT is as effective as it is in adults. This review aims to assess the effects of youth-ACT on severity of psychiatric symptoms, general functioning, and psychiatric hospital admissions. Method A systematic literature search was conducted in PubMed, Cochrane Library, PsychINFO and CINAHL published up to March 2017. To assess methodological quality of the included studies, the Oxford Centre of Evidence-Based Medicine grading system was used. Results Thirteen studies were included in this review. There are indications that youth-ACT is effective in reducing severity of psychiatric symptoms, improving general functioning, and reducing duration and frequency of psychiatric hospital admissions. Conclusions The current literature on youth-ACT is limited but promising. There are indications that youth-ACT is effective in reducing severity of psychiatric symptoms, improving general functioning, and reducing duration and frequency of psychiatric hospital admissions. The effect of youth-ACT may be comparable with the effect of ACT in adults. Similar as in adult ACT, the studies on youth-ACT found effects that vary from small to large. Randomized experimental research designs are needed to further corroborate effectiveness. |
| first_indexed | 2024-12-18T15:18:26Z |
| format | Article |
| id | doaj.art-579bf84f126f4cdda6cf9b2a8362b1df |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-18T15:18:26Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-579bf84f126f4cdda6cf9b2a8362b1df2022-12-21T21:03:28ZengBMCBMC Psychiatry1471-244X2017-08-0117111810.1186/s12888-017-1446-4The effect of youth assertive community treatment: a systematic PRISMA reviewRichard Vijverberg0Robert Ferdinand1Aartjan Beekman2Berno van Meijel3Department of Child and Adolescent Psychiatry, GGZ-DelflandDepartment of Child and Adolescent Psychiatry, GGZ-DelflandVU Medical Centre/GGZ-InGeestDepartment of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical CenterAbstract Background During the past decades deinstitutionalisation policies have led to a transition from inpatient towards community mental health care. Many European countries implement Assertive Community Treatment (ACT) as an alternative for inpatient care for “difficult to reach” children and adolescents with severe mental illness. ACT is a well-organized low-threshold treatment modality; patients are actively approached in their own environment, and efforts are undertaken to strengthen the patient’s motivation for treatment. The assumption is that ACT may help to avoid psychiatric hospital admissions, enhance cost-effectiveness, stimulate social participation and support, and reduce stigma. ACT has been extensively investigated in adults with severe mental illness and various reviews support its effectiveness in this patient group. However, to date there is no review available regarding the effectiveness of youth-ACT. It is unknown whether youth-ACT is as effective as it is in adults. This review aims to assess the effects of youth-ACT on severity of psychiatric symptoms, general functioning, and psychiatric hospital admissions. Method A systematic literature search was conducted in PubMed, Cochrane Library, PsychINFO and CINAHL published up to March 2017. To assess methodological quality of the included studies, the Oxford Centre of Evidence-Based Medicine grading system was used. Results Thirteen studies were included in this review. There are indications that youth-ACT is effective in reducing severity of psychiatric symptoms, improving general functioning, and reducing duration and frequency of psychiatric hospital admissions. Conclusions The current literature on youth-ACT is limited but promising. There are indications that youth-ACT is effective in reducing severity of psychiatric symptoms, improving general functioning, and reducing duration and frequency of psychiatric hospital admissions. The effect of youth-ACT may be comparable with the effect of ACT in adults. Similar as in adult ACT, the studies on youth-ACT found effects that vary from small to large. Randomized experimental research designs are needed to further corroborate effectiveness.http://link.springer.com/article/10.1186/s12888-017-1446-4Assertive community treatmentAssertive outreachAdolescentReview |
| spellingShingle | Richard Vijverberg Robert Ferdinand Aartjan Beekman Berno van Meijel The effect of youth assertive community treatment: a systematic PRISMA review BMC Psychiatry Assertive community treatment Assertive outreach Adolescent Review |
| title | The effect of youth assertive community treatment: a systematic PRISMA review |
| title_full | The effect of youth assertive community treatment: a systematic PRISMA review |
| title_fullStr | The effect of youth assertive community treatment: a systematic PRISMA review |
| title_full_unstemmed | The effect of youth assertive community treatment: a systematic PRISMA review |
| title_short | The effect of youth assertive community treatment: a systematic PRISMA review |
| title_sort | effect of youth assertive community treatment a systematic prisma review |
| topic | Assertive community treatment Assertive outreach Adolescent Review |
| url | http://link.springer.com/article/10.1186/s12888-017-1446-4 |
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