Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Meyer, P. S. Articles by Morrissey, J. P. Search for Related Content PubMed Citation Articles by Meyer, P. S. Articles by Morrissey, J. P. Chronically Mentally Ill Patients Rural and Underserved Patients Access to Services

A Comparison of Assertive Community Treatment and Intensive Case Management for Patients in Rural Areas

OBJECTIVE: This article reviews the evidence for the effectiveness of community-based services for rural areas, specifically assertive community treatment and intensive case management. Service delivery to persons with severe mental illness in rural areas is challenged by low population densities, limited services, and shortages of professionals. METHODS: A comprehensive literature search identified six studies of rural assertive community treatment, only two of which were controlled studies, and four rural intensive case management studies, only one of which was a controlled study. Assertive community treatment would seem ideally suited to areas lacking services because of its self-contained multidisciplinary treatment team approach. However, rural programs have been forced to make several adaptations to the assertive community treatment model, including smaller teams, less comprehensive staff, and less intensive services. There is no published evidence that these adaptations are able to produce the same results as full-fidelity teams. Some believe that intensive case management may be an alternative to assertive community treatment in rural settings because intensive case management emphasizes individual caseloads, fewer staff, less intensive contacts, and brokered services. CONCLUSIONS: The evidence suggests that intensive case management programs are effective only in community settings where there is an ample supply of treatment and support services. To build the evidence base for the effectiveness of these models, much more attention needs to be focused on evaluating the current wave of assertive community treatment and intensive case management dissemination in rural areas.

This article has been cited by other articles:

				J. A. Hall, M. S. Vaughan Sarrazin, D. L. Huber, T. Vaughn, R. I. Block, A. R. Reedy, and MiJin Jang Iowa Case Management for Rural Drug Abuse Research on Social Work Practice, July 1, 2009; 19(4): 407 - 422. [Abstract] [PDF]

				K. R. Isett, M. A. Burnam, B. Coleman-Beattie, P. S. Hyde, J. P. Morrissey, J. Magnabosco, C. A. Rapp, V. Ganju, and H. H. Goldman The State Policy Context of Implementation Issues for Evidence-Based Practices in Mental Health Psychiatr Serv, July 1, 2007; 58(7): 914 - 921. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2007 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us