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BMC Psychiatry
Published in: BMC Psychiatry 1/2010

Open Access 01-12-2010 | Study protocol

Assertive community treatment for elderly people with severe mental illness

Authors: Jolanda Stobbe, Niels CL Mulder, Bert-Jan Roosenschoon, Marja Depla, Hans Kroon

Published in: BMC Psychiatry | Issue 1/2010

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Abstract

Background

Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness.

Methods

We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months.

Discussion

This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated.

Trial Registration

The Netherlands National Trial Register NTR1620
Appendix
Available only for authorised users
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Metadata
Title
Assertive community treatment for elderly people with severe mental illness
Authors
Jolanda Stobbe
Niels CL Mulder
Bert-Jan Roosenschoon
Marja Depla
Hans Kroon
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2010
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-10-84

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