Assertive Community Treatment and Associations with Substance Abuse Problems

Maaike D. van Vugt*, Hans Kroon, Philippe A. E. G. Delespaul, Cornelis L. Mulder

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


This study examined the associations between substance abuse problems in severely mentally ill patients, outcome and Assertive Community Treatment (ACT) model fidelity. In a prospective longitudinal study, ACT model fidelity and patient outcomes were assessed in 20 outpatient treatment teams using the Health of the Nation Outcome Scales, Camberwell Assessment of Needs short appraisal schedule and measures of service use. Five hundred and thirty severely mentally ill patients participated in the study. Substance abuse problems were assessed three times during a 2-year follow-up period. This study found that among patients with severe mental illness, patients with an addiction problem had more serious psychosocial problems at baseline. Substance abuse problems showed improvement over time, but this was not associated with ACT model fidelity. The study indicates that investment by teams to improve a patient's psychosocial situation can lead to improvements on substance problems.
Original languageEnglish
Pages (from-to)460-465
JournalCommunity Mental Health Journal
Issue number4
Publication statusPublished - May 2014


  • Assertive community treatment
  • Substance abuse
  • Outcome assessment
  • Model fidelity
  • Psychosocial problems
  • Evidence-based care

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