What? Another form? The process of measuring and comparing service utilization in a community mental health program model

Although Assertive Community Treatment (ACT) is one of the most widely studied of all community mental health treatment models, the process through which it produces outcomes is often treated as a 'black box'. There is limited understanding of the model's essential elements and studies seldom describe program implementation, As a result, though localities may be interested in developing an ACT team, information necessary for implementation of the model (e.g. costing, cost-effectiveness, ACT service utilization) is inadequate to help plan services. Part of this gap in the literature can be attributed to the fact that the vital pieces of information needed to produce the much needed estimates are generally the most arduous to gather; they require daily recording of activities and hence, the participation of already overburdened program staff. The purpose of this paper is to describe our experiences in developing a multi-program economic evaluation and costing study of ACT. In discussing the process that we followed, we hope to pass on useful information that will help produce effective and efficient mental health evaluations in the future. Our project offers an example of how the worlds of research and service delivery can collaborate to come to symbiotic resolutions. Together, we have been able to collect data that is not only valuable for program evaluation but beneficial for administrative purposes to define priority areas, staffing and service planning. (C) 2001 Elsevier Science Ltd. All rights reserved.