LeFebvre Andrea M, Dare Bill, Farrell Susan J, Cuddeback Gary S
Community Mental Health Program, The Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada.
Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada.
Community Ment Health J. 2018 May;54(4):469-479. doi: 10.1007/s10597-017-0162-3. Epub 2017 Sep 1.
An emerging focus of Assertive Community Treatment (ACT) teams is the transition of clients to less intensive services, which creates space for individuals in need of ACT and is consistent with a recovery orientation of treatment. However, there is limited research on team transition rates, post-ACT services, and strategies to overcome transition barriers. In addition, few studies have examined differences in these factors among urban and rural ACT teams. To address these knowledge gaps, we interviewed eight ACT teams in urban and rural areas of eastern Ontario regarding their transition rates, processes of transitioning ACT clients to less intensive services, transition barriers, and solutions to overcoming these barriers. On average, teams transitioned about 6% of their clients over our 3-year study period. Urban and rural teams described both similar and distinct clinical and systemic barriers, such as client reluctance to transition and finding psychiatric follow-up outside of ACT. Implications for ACT practice and policy are discussed.
积极社区治疗（ACT）团队的一个新重点是将服务对象过渡到强度较低的服务，这为需要ACT服务的个人创造了空间，并且与治疗的康复导向相一致。然而，关于团队过渡率、ACT后服务以及克服过渡障碍的策略的研究有限。此外，很少有研究考察城市和农村ACT团队在这些因素上的差异。为了填补这些知识空白，我们采访了安大略省东部城市和农村地区的八个ACT团队，了解他们的过渡率、将ACT服务对象过渡到强度较低服务的过程、过渡障碍以及克服这些障碍的解决方案。在我们为期3年的研究期间，各团队平均将约6%的服务对象进行了过渡。城市和农村团队描述了类似和不同的临床及系统障碍，如服务对象不愿过渡以及在ACT之外寻找精神科后续治疗。文中还讨论了对ACT实践和政策的启示。
