The DOI matches its Crossref record; 51 of the 52 references it cites were found in a registry or an index.
Forty-five years later: the challenge of optimizing assertive community treatment
Abstract
PURPOSE OF REVIEW: Assertive Community Treatment is an established evidenced based practice that provides intensive community treatment for individuals with severe mental illness with recurrent hospitalizations and/or homelessness. Emerging evidence indicates limitations in its implementation in terms of to the original ACT model and its current relevance. RECENT FINDINGS: Findings from recent studies (2018-2020) reveals challenges with implementation centered around basic implementation activities, such as changes in the psychosocial context of individuals with SMI, clinicians' abilities to demonstrate competencies with new practices, and ongoing evolution of mental health systems of care worldwide. Intermediary and purveyor organizations (IPO) can provide the infrastructure to support the spread of EBPs while addressing challenges and opportunities. Thus, implementation of ACT can be accomplished when employing a rigorous framework and infrastructure that can synthesize and translate science relevant for practice. SUMMARY: The relevance of ACT depends on its implementation that is responsive to change. An implementation science-informed approach is key to providing ACT to individuals in the critical space between the hospital and community. With this approach, we can optimize ACT as a service delivery vehicle by careful analysis of how best to furnish and evaluate the latest, most effective and efficient treatments, rehabilitation and support services.
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“The language of “in or through a designated facility” enables psychiatric treatment to be administered without a patient’s or substitute decision-maker’s consent either at a designated hospital on an in-patient basis (where the patient is detained), or in a community setting, for example, when treatment is delivered by Assertive Community Treatment teams [4,5].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [4]
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Assertive Community Treatment: Twenty-Five Years of Gold
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Self-citationThe Learning Healthcare System: Where are we now? A systematic review
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Research works printed but not linked: 2
- Stuen, 2018, Responsibilities with conflicting priorities: a qualitative study of ACT providers’ experiences with community treatment orders, BMC Health Serv Res, 18, 290, 10.1186/s12913-018-3097-7 · DOI
- Thorning, 2016, Adoption of a Blended Training Curriculum for ACT in New York State, Psychiatric Services, 10.1176/appi.ps.201600143 · DOI
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Crystal, S., Nowels, M., Samples, H., Olfson, M., Williams, A. R., & Treitler, P. C. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109269 · Cited by 22
Examining Youth Flexible ACT Model Implementation in the Netherlands
Broersen, M., Frieswijk, N., van Vugt, M., Vermulst, A. A., Creemers, D. H. M., & Kroon, H. (2024) · Community Mental Health Journal · doi:10.1007/s10597-024-01260-z · Cited by 7
Yamaguchi, S., Usui, K., Iwanaga, M., Kawaguchi, T., Hada, A., Yoshida, K., Nishio, M., Yanata, H., Watanabe, M., Taniguchi, K., et al. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-085532 · Cited by 7
Peritogiannis, V., & Tsoli, F. (2021) · Psych · doi:10.3390/psych3040050 · Cited by 7
Smeekens, M. V., Sappelli, F., de Vries, M. G., & Bulten, B. H. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.708722 · Cited by 6
Metadata
- Authors
- Thorning, H., & Dixon, L.
- Affiliations
- New York State Psychiatric Institute (US)
- Corresponding author
- Thorning, Helle
- Venue
- Current Opinion in Psychiatry
- Published
- 2020-07
- Volume
- 33
- Issue
- 4
- Pages
- 397-406
- ISSN
- 0951-7367 (ISSN-L)
- 1473-6578
- OpenAlex
- W3030872904
- Cited by
- 34
- References
- 52
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 9 · 2023: 2 · 2022: 6 · 2021: 5
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Keywords
- assertive community treatment, severe mental illness, implementation science, evidence-based practice dissemination, mental health service delivery, homelessness, hospitalization, clinician competence
- MeSH terms
- Mental Disorders, Community Mental Health Services, Delivery of Health Care, Humans, Evidence-Based Practice
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