Columbia University School of Social Work, New York, NY 10027, USA.
Adm Policy Ment Health. 2012 May;39(3):170-9. doi: 10.1007/s10488-011-0344-1.
The Assertive Community Treatment (ACT) model for people with severe mental illness has typically been viewed as a time-unlimited intervention. Without a proscribed service duration, discharge from ACT largely depends on individual clients' situations and practitioners' discretion. We conducted semi-structured focus groups and interviews with practitioners to explore their discharge practices and considerations. Results highlight the heterogeneity of the clientele served in ACT, and therefore the importance of individualized treatment and discharge planning, guidance on assessing the timing of discharge for individual cases, practice strategies that balance independence and social connectedness to promote recovery, and the need for substantial system reform to facilitate transition after discharge.
对于患有严重精神疾病的人，采用的是坚定社区治疗（ACT）模式，该模式通常被视为一种无时间限制的干预措施。由于没有规定的服务期限，因此 ACT 的出院主要取决于个人客户的情况和从业者的酌处权。我们对从业者进行了半结构化的焦点小组和访谈，以探讨他们的出院实践和考虑因素。结果突出了 ACT 所服务的客户群体的异质性，因此需要个性化的治疗和出院计划、指导如何评估个别病例的出院时间、平衡独立性和社交联系以促进康复的实践策略，以及需要进行大量的系统改革以促进出院后的过渡。
