BACKGROUND: Homelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed. AIMS: To evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland. METHODS: A total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed. RESULTS: Compared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0.58 in favour of ACT. Patterns of care and costs varied according to race. CONCLUSION:ACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.
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BACKGROUND: Homelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed. AIMS: To evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland. METHODS: A total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed. RESULTS: Compared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0.58 in favour of ACT. Patterns of care and costs varied according to race. CONCLUSION: ACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.
Authors: Gary A Morse; Robert J Calsyn; W Dean Klinkenberg; Thomas W Helminiak; Nancy Wolff; Robert E Drake; Robert D Yonker; Gyanesh Lama; Matthew R Lemming; Suzanne McCudden Journal: Community Ment Health J Date: 2006-08-04
Authors: Joyce C West; Donald S Rae; Ramin Mojtabai; Farifteh F Duffy; Janet Kuramoto; Eve Moscicki; William E Narrow Journal: Community Ment Health J Date: 2015-02-10
Authors: Lisa B Dixon; Faith Dickerson; Alan S Bellack; Melanie Bennett; Dwight Dickinson; Richard W Goldberg; Anthony Lehman; Wendy N Tenhula; Christine Calmes; Rebecca M Pasillas; Jason Peer; Julie Kreyenbuhl Journal: Schizophr Bull Date: 2009-12-02 Impact factor: 9.306