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Implementation of Assertive Community Treatment in Australia: Model Fidelity, Patient Characteristics and Staff Experiences

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Abstract

The impact of variable implementation of the Assertive Community Treatment (ACT) model on patient outcomes is increasingly recognised. We conducted the first study of four established Australian ACT teams, examining team composition, processes and model fidelity, using previously validated questionnaires. Demographic and clinical details of patients and their own experiences of ACT were gathered from staff. Associations between burnout and work experiences were examined. All teams were ACT-like (mean DACTS score = 3.7, SD = 0.3) with few significant patient differences between teams, except diagnosis (schizophrenia 61–93%, co-morbid substance abuse 16–33%) and proportion living alone (23–72%). Clinicians were fairly satisfied, but inter-team differences in staffing profile and experience emerged and one team scored highly on emotional exhaustion. Increased burnout was associated with greater stress due to taking a team approach. Inter-team differences suggested that attention to effective team working and leadership, as well as model fidelity, may be warranted.

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Acknowledgments

The authors thank all the MSTT team leaders and clinicians who participated in this study.

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Author notes

  1. Salvatore Martino

    Present address: , 286 Taronga Rd, Glen Iris, VIC, 3146, Australia

Authors and Affiliations

  1. Department of Psychiatry, The University of Melbourne & North Western Mental Health, Psychosocial Research Centre, 130 Bell Street, Coburg, VIC, 3058, Australia

    Carol Harvey

  2. Department of Mental Health Sciences, University College London and Camden and Islington NHS Foundation Trust, Royal Free Hospital, London, NW3 2PF, UK

    Helen Killaspy

  3. South West Area Mental Health Service, Melbourne, VIC, Australia

    Salvatore Martino

  4. Research Department of Mental Health Sciences, University College London and Camden and Islington NHS Foundation Trust, Charles Bell House, 67–73 Riding House Street, London, W1W 7EY, UK

    Sonia Johnson

Authors
  1. Carol Harvey
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  2. Helen Killaspy
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  3. Salvatore Martino
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  4. Sonia Johnson
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Correspondence to Carol Harvey.

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Harvey, C., Killaspy, H., Martino, S. et al. Implementation of Assertive Community Treatment in Australia: Model Fidelity, Patient Characteristics and Staff Experiences. Community Ment Health J 48, 652–661 (2012). https://doi.org/10.1007/s10597-011-9466-x

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  • DOI: https://doi.org/10.1007/s10597-011-9466-x

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