Morbidity and mortality due to physical illness is extremely high in the population of persons with serious mental illness. The purpose of this study was to examine the impact on psychiatric and physical outcomes through enhancing a standard Program of Assertive Community Treatment (PACT) with Advanced Practice Psychiatric Mental Health Nurses (APNs) and stabilized consumer peer providers (NPACT). In a two-group community comparison design, 38 participants receiving NPACT were compared to 21 participants receiving traditional PACT. Evaluations were conducted at baseline and 6 months. Significant improvements over time were demonstrated for both groups on all summary variables. Treatment effects for NPACT over PACT were demonstrated for psychiatric symptoms, community functioning, and consumer satisfaction. Conclusions: Enhancements for PACT using advanced practice nurses and consumer peer providers have the potential to address both health and mental health problems for the seriously mentally ill.
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We thank the clients, staff and the administration of the Community Services Boards who participated in this study and appreciate the special contributions of the consumer peer providers. We recognize with thanks Sid McColley, RN, MSN, CS and Kelley Midkiff, RN, MSN, CS, FNP, at Region Ten Community Services Board, Charlottesville, Virginia for their contributions in advanced practice nursing, and thank Bonnie Gray and Hunsa Sethabouppha who managed the procedures, the data and preliminary analyses. The study was supported by NIMH Grant P50-MH49173 through the Southeastern Rural Mental Health Research Center at UVA.
- assertive community treatment
- health promotion