Effectiveness of Hybrid Assertive Community Treatment in Rural Greece: Improving Outcomes for Severe Mental Illness Patients

Introduction:

In rural areas, Modified Assertive Community Treatment (ACT) could prove pivotal in managing severe mental illness (SMI) in patients that are difficult to engage in community care. The objective of the present study was to assess the impact of a hybrid ACT team on SMI patients' hospitalizations, their length of hospital stay, their symptomatology, and their functioning within a rural community treatment setting in Greece.

Methods:

Expanding the services of a well-established Mobile Mental Health Unit, the hybrid ACT team delivers home-based care for SMI patients in a rural area of northwest Greece. This 3-year prospective, mirror-image, pre–post observational study evaluates patients' symptomatology, functioning, and overall outcome using three validated scales: the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning Scale (GAF), and the Health of the Nation Outcome Scale (HοNOS).

Results:

Among the 23 enrolled patients (mean age: 52.4 years; mean age of disease onset: 23.5 years; mean hospitalizations: 10.74), voluntary and involuntary hospitalizations decreased by nearly 80% over a 16-month follow-up. Length of hospital stay was reduced significantly by 87%, with notable improvements in patients’ functioning (17%) and symptomatology (14.5%).

Conclusions:

This study highlights the efficacy of a hybrid Assertive Community Treatment model in rural Greece for patients with severe mental illness, demonstrating significant reductions in hospitalizations and length of stay and improvements in symptomatology and functioning, suggesting its potential to address the needs of difficult-to-engage SMI patients and enhance their overall outcomes.