An exploratory and descriptive analysis of client satisfaction and outcome realization for central health's assertive community treatment team

Pope, Leslie M. (2013) An exploratory and descriptive analysis of client satisfaction and outcome realization for central health's assertive community treatment team. Masters thesis, Memorial University of Newfoundland.

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Abstract

The main objectives of this study were to provide a description of the service delivery model of an assertive community treatment (ACT) team in central Newfoundland and Labrador and to examine the characteristics of ACT service users, their degree of satisfaction with ACT, and whether their engagement with ACT had resulted in a reduced reliance on acute psychiatric services. A recently completed DACTS report, along with researcher immersion and informal interviews with the ACT team, were used as informational sources to explore the team's adherence to the ACT evidence-based model. Chart audits were completed to collect data on participant characteristics. Days of psychiatric admission and emergency room (ER) visits were collected retrospectively for participants based on their individual pre- and post-ACT engagement time periods. Twenty-nine ACT clients agreed to participate in this study. The majority of participants (82.8%) were male and diagnosed with schizophrenia or a schizoaffective disorder (65.5%). There was a high rate of concurrent substance abuse (75.9%). The main outcome measures were the number of readmission days and ER visits before and after ACT engagement. The average number of readmission days reduced from 14 to zero (p <.05) following engagement with ACT. The average number of visits to ERs also reduced from three to one (p < .05). Participants reported overall high satisfaction with ACT services. Responses were highly concentrated with references to emotional and instrumental support. This study articulates how model fidelity translates into practice. Its findings contribute to the current literature, which associates higher model fidelity with improved client outcomes related to acute psychiatric services. The need for provincial cross-site comparisons and repeated program assessments of ACT are substantiated.

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