Outcomes of Integrated Assertive Community Treatment for Homeless Consumers With Co-occurring Disorders

Abstract

The objective of this research was to evaluate the impact of Integrated Assertive Community Treatment (I-ACT) on psychiatric symptoms, drug use, housing status, and service utilization. A single-group repeated measures evaluation of outcome indicators at intake, 6 months, and 12 months examined changes over time with 555 respondents receiving outpatient treatment. While 555 received baseline interviews, figures vary on follow-up sample sizes and are listed as they are discussed in the paper. The study was implemented by a community treatment provider. The primary analyses used in this study were repeated measures ANOVA and the Friedman's two-way analysis test. Significant reductions in substance use (F(1.69, 553.02) = 94.30, p < .01) and psychiatric symptoms (F(1.98, 299.19) = 43.73, p = .0001) were found from baseline to 6 months and changes were sustained from the 6- to 12-month follow-up points. Similar results were found in housing status with the number of participants in stable housing rising significantly. Utilization of substance use and psychiatric treatment declined significantly across all three follow-up points, and physical health service use remained unchanged. I-ACT has demonstrated efficacy through controlled research studies, and this evaluation extends on these findings to demonstrate that I-ACT is effective in community service provision settings in reducing substance use and psychiatric symptoms. Further, the reduction in service use found across follow-up points indicates cost containment.

KEYWORDS:

• Substance use
• co-occurring disorders
• assertive community treatment
• integrated treatment

This project was supported by funds from the Substance Abuse Mental Health Services Administration/Center for Substance Abuse Treatment Grant T1-12964. The views and opinions contained in the publication do not necessarily reflect those of the Center for Substance Abuse Treatment, the Substance Abuse and Mental Health Services Administration, or the U.S. Department of Health and Human Services and should not be construed as such.

Notes

^aHunyh-Feldt correction;

^bGreenhouse-Geisser correction.

^aHunyh-Feldt correction;

^bGreenhouse-Geisser correction.