Abstract
While Assertive Community Treatment (originally known as the PACT program) is now recognized around the world as an effective model for rehabilitation of persons with severe mental illness, this was not the case 20 years ago. Harbinger of Grand Rapids, in Kent County, Michigan, was the first replication of the PACT model which sought fidelity and included an experimental design for assessing effectiveness. The design and results are presented from an initial 30-month and a follow-up 66-month evaluation of Harbinger. The 30-month evaluation showed significant differences favoring Harbinger vs. the control group on independent living, employment, and client functioning. At 66-months, there were fewer experimental-control group differences. The differences in results are analyzed in terms of design and data collection problems, changes in the treatment environment for the control group, and the longitudinal course of mental illness. The discussion focuses on next steps in ACT research, utilizing program theory to better establish the mechanisms for successful intervention models.
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REFERENCES
Bachrach, L.L. (1988). On exporting and importing model programs. Hospital & Community Psychiatry, 39, 1257–1258.
Burns, B.J., & Santos, A.B. (1995). Assertive community treatment: An update of randomized trials. Psychiatric Services, 46, 669–675.
Chen, H. (1990). Theory-driven evaluations. Newbury Park, CA: Sage Publications.
Drake, R.E., & Burns, B.J. (1995). Special section on assertive community treatment: An introduction. Psychiatric Services, 46, 667–668.
Harding, C.M., Zubin, J., & Strauss, J.S. (1987). Chronicity in schizophrenia: Fact, partial fact, or artifact? Hospital & Community Psychiatry, 38, 477–486.
Humphreys, K., & Rappaport, J. (1993). From the community mental health movement to the war on drugs: A study in the definition of social problems. American Psychologist, 48, 892–901.
Johnson, A.B. (1990). Out of Bedlam. New York: Basic Books.
Kiesler, C.A. (1982). Mental hospitals and alternative care: Noninstitutionalization as potential public policy for mental patients. American Psychologist, 37, 349–360.
McGrew, J.H., & Bond, G.R. (1995). Critical ingredients of assertive community treatment: Judgements of the experts. Journal of Mental Health Administration, 22(2), 113–125.
McGrew, J.H., Bond, G.R., Dietzen, L., Salyers, M. (1994). Measuring the fidelity of implementation of a mental health program model. Journal of Consulting & Clinical Psychology, 62, 670–678.
Mowbray, C.T., Plum, T.B., & Masterton, T. (1997). Harbinger II: Deployment and evolution of assertive community treatment in Michigan. Administration and Policy in Mental Health, 25, 125–139.
Mulder, R. (1982). Final evaluation of the Harbinger Program as a demonstration project. Lansing, MI: Michigan Department of Mental Health.
Mulder, R. (1986). Evaluation of the Harbinger Program: 1982–1985. Lansing, MI: Michigan Department of Health.
Olfson, M. (1990). Assertive community treatment: An evaluation of the experimental evidence. Hospital & Community Psychiatry, 41, 634–641.
Tableman, B. (1989). Installing prevention programming in the public mental health system. American Journal of Community Psychology, 17(2), 171–183.
Taube, C.A., Morlock, L., Burns, B.J., & Santos, A.B. (1990). New directions in research on assertive community treatment. Hospital & Community Psychiatry, 41, 642–647.
Thompson, K.S., Griffith, E.E., & Leaf, P.J. (1990). A historical review of the Madison model of community care. Hospital & Community Psychiatry, 41, 625–634.
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Mowbray, C.T., Collins, M.E., Plum, T.B. et al. Harbinger I: The Development and Evaluation of the First PACT Replication. Adm Policy Ment Health 25, 105–123 (1997). https://doi.org/10.1023/A:1022230803615
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DOI: https://doi.org/10.1023/A:1022230803615