Evaluating professionally operated and self-help programs for the seriously mentally ill

Abstract

Reviewed a study by Bond et al. (1990) that evaluates assertive community treatment (ACT), an intensive community-based program for the seriously mentally ill. Such programs have been developed at a rapid pace in recent years but lack extensive research support. This randomized study supports the effectiveness of ACT and is a significant contribution to the mixed findings from the existing literature. However, its methodological flaws include (a) differential dropout from the ACT and comparison groups, (b) a relatively short follow-up period (12 months), and (c) limitations of the ACT intervention which prevents rehospitalization but lacks impact in other domains (e.g., social relationships, housing stability, employment). Self-help programs, poorly represented by the comparison group in this research, may offer the sorts of societal niches required by the mentally ill. Further research, giving such programs a "fair shake" against professionally controlled programs, is sorely needed.