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J Psychiatry Neurosci. 2005 Sep;30(5):355-9.

Economic considerations associated with assertive community treatment and supported employment for people with severe mental illness.

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Douglas Hospital Research Centre, Borough of Verdun, and Department of Psychiatry, McGill University, Montréal, Quebec, Canada.


This article discusses economic considerations associated with evidence-based practices for people with severe mental illness that involve grouping treatment and rehabilitation staff into a single team. The article includes a brief review of the evidence and arguments that both assertive community treatment and supported employment are effective in promoting recovery, as well as having other favourable outcomes. In terms of cost, assertive community treatment appears to allow flexible deployment of resources such that the number of days in hospital is reduced, which means that in many cases this form of treatment pays for itself. Evidence for a similar cost offset with supported employment is much more limited. Even when such practices increase overall costs, they appear to be more cost-effective than the alternatives with which they have been compared. Consideration of these findings together suggests that improved synthesis and use of individual-level clinical information, which are more easily achieved by a team, are key to more cost-effective service delivery for people who need the expertise of different kinds of professionals.

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