Epidemiology and Psychiatric Sciences

Original Articles

Function assertive community treatment (FACT) and psychiatric service use in patients diagnosed with severe mental illness

M. Drukkera1 c1, J. Van Osa1a2, S. Sytemaa3, G. Driessena1, E. Vissera3 and Ph. Delespaula1a4

a1 Department of Psychiatry and Psychology, School for Mental Health and Neuroscience MHeNS, Maastricht University, The Netherlands

a2 King's Health Partners Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK

a3 Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

a4 Integrated Care Division, Mondriaan, South-Limburg, The Netherlands


Aim. Previous work suggests that the Dutch variant of assertive community treatment (ACT), known as Function ACT (FACT), may be effective in increasing symptomatic remission rates when replacing a system of hospital-based care and separate community-based facilities. FACT guidelines propose a different pattern of psychiatric service consumption compared to traditional services, which should result in different costing parameters than care as usual (CAU).

Methods. South-Limburg FACT patients, identified through the local psychiatric case register, were matched with patients from a non-FACT control region in the North of the Netherlands (NN). Matching was accomplished using propensity scoring including, among others, total and outpatient care consumption. Assessment, as an important ingredient of FACT, was the point of departure of the present analysis.

Results. FACT patients, compared to CAU, had five more outpatient contacts after the index date. Cost-effectiveness was difficult to assess.

Conclusion. Implementation of FACT results in measurable changes in mental health care use.

(Received November 01 2010)

(Revised March 09 2011)

(Accepted March 09 2011)


c1 Address for correspondence: Dr Marjan Drukker, Department of Psychiatry and Psychology, School for Mental Health and NeuroScience MHeNS, Maastricht University, P.O. Box 616, Vijverdal, 6200 MD Maastricht, The Netherlands. (Email: Marjan.Drukker@MaastrichtUniversity.nl)