The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Psychiatric Hospitalizations, Arrests, Emergency Room Visits, and Homelessness of Clients with Serious and Persistent Mental Illness: Findings from a Randomized Trial of Two ACT Programs vs. Usual Care
Abstract
Objective This investigation examined several adverse outcomes in clients with serious mental illness in a randomized trial of Assertive Community Treatment (ACT) versus usual care. Method 163 subjects were randomized to one of two ACT experimental conditions (staffed by consumers or non-consumers) or usual community care. Conditions were compared on psychiatric hospitalization, emergency room visit, arrest, and homelessness, within the two-year study period. Demographic, program, and client variables were examined for significant associations with outcomes. Results Significant differences were found between ACT and usual care in time to first arrest, but not hospitalization, homelessness or ER visits. Shorter time to first hospitalization was associated with male gender, diagnoses other than schizophrenia, high psychiatric symptomatology and lower provider case load. ER visits were associated with increased client symptomatology. Shorter times to homelessness were predicted by poorer therapeutic alliance between case manager and clients. Shorter time to first arrest was predicted by client minority status and enrollment in usual care. Conclusions The paucity of significant main effects may have been due to a prolonged "start-up" phase of the ACT programs, poor ACT implementation, restricted availability of psychiatric hospital beds, or changes in usual care services delivered over the study period.
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“Interventions such as assertive community treatment (ACT) seek to prevent homelessness among individuals with mental illness and to address behavioral disorders (mainly substance use disorders, psychotic disorders, and depressive disorders [62]) and could help reduce the risk for arrest among homeless people (63).”
From Referral of patients to psychiatric emergency departments by police: A systematic review and meta-analysis (2025) · cites this paper as [63]
Citations
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The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014) · Psychological Science in the Public Interest · doi:10.1177/1529100614531398 · Cited by 1,642
A Handbook for the Study of Mental Health Second Edition
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A review of the literature on peer support in mental health services
Repper, J., & Carter, T. (2011) · Journal of Mental Health · doi:10.3109/09638237.2011.583947 · Cited by 1,103
Peer Support/Peer Provided Services Underlying Processes, Benefits, and Critical Ingredients.
Solomon, P. (2004) · Psychiatric Rehabilitation Journal · doi:10.2975/27.2004.392.401 · Cited by 1,060
Peer support among persons with severe mental illnesses: a review of evidence and experience
DAVIDSON, L., BELLAMY, C., GUY, K., & MILLER, R. (2012) · World Psychiatry · doi:10.1016/j.wpsyc.2012.05.009 · Cited by 913
Metadata
- Authors
- Clarke, G. N., Herinckx, H. A., Kinney, R. F., Paulson, R. I., Cutler, D. L., Lewis, K., & Oxman, E.
- Affiliations
- Kaiser Permanente Center for Health Research (US)
- Portland State University (US)
- Corresponding author
- Clarke, Gregory N.
- ORCID
- Clarke, Gregory N.
- Venue
- Mental Health Services Research
- Published
- 2000-09
- Volume
- 2
- Issue
- 3
- Pages
- 155-164
- ISSN
- 1522-3434 (ISSN-L)
- 1573-6636
- OpenAlex
- W1570195765
- Semantic Scholar
- ec1aa7389078636f94d7d1e57964430f228d2043
- Cited by
- 223
- References
- 29
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 1 · 2023: 6 · 2022: 2 · 2021: 11 · 2020: 9 · 2019: 7 · 2018: 7 · 2017: 52 · 2016: 8 · 2015: 5 · 2014: 8 · 2013: 14 · 2012: 12
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Mental Health Services Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Sociology and Political Science › Homelessness and Social Issues
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- assertive community treatment, severe mental illness, psychiatric hospitalization, emergency department visits, arrests, homelessness, therapeutic relationship, psychiatric symptom severity, minority status
- MeSH terms
- Adult, Mental Disorders, Community Mental Health Services, Emergency Services, Psychiatric, Female, Ill-Housed Persons, Hospitalization, Humans, Male, Severity of Illness Index, United States, Program Evaluation, Treatment Outcome
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