RURAL ASSERTIVE COMMUNITY TREATMENT PROJECT

印第安纳州精神卫生部与五个社区合作， 为农村集水区和印第安纳州提供服务的精神卫生中心 普渡大学印第安纳波利斯分校，建议评估 新的自信社区治疗（ACT）团队在四个CMHC的疗效。 每个站点都将有一个实验条件， ACT服务加上现有的CMHC服务，以及控制条件， 有资格获得CMHC的所有服务，ACT除外。第五 CMHC将用于实验性评估替代病例管理器 方法，莱因兰德模型。第五个网站还将提供 ACT和莱因兰德方法之间的非实验性比较。 拟议项目的重点是评估以下方面的功效： 农村个案管理服务。对农村问题的研究存在很大空白， 与人口稠密地区的计划相比。更广泛的重点是 将本研究纳入ACT研究计划的矩阵中 模型 评价的重点将是：（1）客户成果，如减少 住院治疗，提高生活质量，改善角色功能， 更好的居住和财务稳定性，药物依从性， 参与法律的系统;（2）案件管理服务， 联系的频率、持续时间和类型，以及（3）成本效益分析， 包括使用CMHC服务、医院使用、病例管理服务，以及 法律的制度介入。

The Indiana Department of Mental Health, in cooperation with five Community Mental Health Centers (CMHCS) serving rural catchment areas and Indiana University-Purdue University at Indianapolis, proposes to evaluate the efficacy of new assertive community treatment (ACT) teams at four CMHCs. Each site will have both an experimental condition that will receive the ACT services plus existing CMHC services, and a control condition that will be eligible to receive all the services of the CMHC except ACT. A fifth CMHC will be used to evaluate experimentally an alternative case manager approach, the Rhinelander model. This fifth site will also provide nonexperimental comparisons between the ACT and the Rhinelander approach. The narrow focus of the proposed project is to evaluate the efficacy of rural case management services. There is a large gap in research on rural programs compared to ones in more populated areas. The broader focus is to embed this study within the matrix of a program of research on the ACT model. The focus of the evaluation will be: (1) client outcomes, such as reduced hospitalization, increased quality of life, improved role functioning, greater residential and financial stability, medication compliance, involvement with the legal system; (2) case management services in terms of frequency, duration, and types of contacts, and (3) cost-benefit analysis, including use of CMHC services, hospital use, case management services, and legal system involvement.