{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T20:08:31Z","timestamp":1774555711014,"version":"3.50.1"},"reference-count":27,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":6851,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[1999,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Homelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0. 58 in favour of ACT. Patterns of care and costs varied according to race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.174.4.346","type":"journal-article","created":{"date-parts":[[2008,10,15]],"date-time":"2008-10-15T05:41:36Z","timestamp":1224049296000},"page":"346-352","source":"Crossref","is-referenced-by-count":92,"title":["Cost-effectiveness of assertive community treatment for homeless persons with severe mental illness"],"prefix":"10.1192","volume":"174","author":[{"given":"Anthony F.","family":"Lehman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Dixon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey 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