Assertive Community Treatment, helps when hospital use is high

In clinical trials of intensive case management for people with severe mental illness inconsistent effects on the use of hospital care are reported. In a systematic review published in the British Medical Journal this seems to be related to high hospital use by the participants. Intensive case management works best when participants tend to use a lot of hospital care and less well when they do not. It might not be necessary to apply the full model of assertive community treatment to achieve reductions in inpatient care, but focus on the patients that get hospitalised frequently.