{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:11:01Z","timestamp":1788873061355,"version":"build-2803163510"},"reference-count":36,"publisher":"Ubiquity Press, Ltd.","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["Grant No. # 60-26 63800-98-5600"],"award-info":[{"award-number":["Grant No. # 60-26 63800-98-5600"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Integr Care"],"abstract":"<jats:p>Introduction: To promote recovery of individuals with severe mental illness and reduce fragmentation of care, network partners collaborated to develop a cross-domain, multi-agency approach by integrating Flexible Assertive Community Treatment (FACT) teams with municipal District Social Services (DSS), referred to as FACT+DSS teams.Aim: To describe how team members experienced the implementation of the FACT+DSS teams by team members, including perceived effects on various themes such as service delivery, network collaboration, the target population, and facilitators and barriers to implementation.Methods: A qualitative study using semi-structured interviews (N = 15) was conducted to explore the experiences of team members in two new FACT+DSS teams in the Netherlands using thematic analysis.Results: The FACT+DSS approach was experienced to improve service access, continuity of care, case-finding and client enrolment (care-avoiders), time efficiency for team members, and strengthen network collaboration. Identified barriers and facilitators underlined the importance of strong leadership, ownership, equality, direct relationships, and professional expertise.Conclusion: Participants experienced the FACT+DSS approach as a highly positive development, improving network collaboration and recovery-oriented care for clients. Our findings may contribute to the development and implementation of FACT (and related practices) as an integrated multi-agency approach.<\/jats:p>","DOI":"10.5334\/ijic.9794","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:08:31Z","timestamp":1788865711000},"page":"16","source":"Crossref","is-referenced-by-count":0,"title":["The Integration of Flexible Assertive Community Treatment with District Social Support Service Teams for Patients with Severe Mental Illness in the Netherlands: A Qualitative Analysis of Team Members\u2019 Experiences"],"prefix":"10.5334","volume":"26","author":[{"given":"Anne","family":"Kleijburg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1746-1236","authenticated-orcid":false,"given":"Christien","family":"Muusse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7993-1905","authenticated-orcid":false,"given":"Ben","family":"Wijnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9949-5442","authenticated-orcid":false,"given":"Joran","family":"Lokkerbol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"Candel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7242-991X","authenticated-orcid":false,"given":"S. Kor","family":"Spoelstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. C. Marjolijne","family":"de Jong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1026-570X","authenticated-orcid":false,"given":"Silvia","family":"Evers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2259-1628","authenticated-orcid":false,"given":"Hans","family":"Kroon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"key20260908110819_B1","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1176\/ajp.147.12.1602","article-title":"An empirical literature review of definitions of severe and persistent mental illness","volume":"147","year":"1990","journal-title":"American Journal of Psychiatry"},{"key":"key20260908110819_B2","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3109\/09638237.2012.670888","article-title":"Recovery grows up","volume":"21","year":"2012","journal-title":"Journal of Mental Health"},{"key":"key20260908110819_B3","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1192\/bjp.bp.110.083733","article-title":"Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis","volume":"199","year":"2011","journal-title":"British Journal of Psychiatry"},{"key":"key20260908110819_B4","first-page":"815","article-title":"Functioneel herstel en zelfregulatie: opgaven voor cli\u00ebnten \u00e9n psychiaters","volume":"57","year":"2015","journal-title":"Tijdschift Voor Psychiatrie"},{"key":"key20260908110819_B5","volume-title":"Facilitating recovery in people with psychosis","year":"2022"},{"key":"key20260908110819_B6","article-title":"Does FACT have a Future?"},{"issue":"4","key":"key20260908110819_B7","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s10597-007-9089-4","article-title":"FACT: A Dutch Version of ACT","volume":"43","year":"2007","journal-title":"Community Mental Health Journal"},{"key":"key20260908110819_B8","article-title":"FACT Scale version 2017-R","year":"2022"},{"key":"key20260908110819_B9","article-title":"Development of the updated Flexible ACT-scale: F-ACT-s 2017 [Dutch article]","volume":"97","year":"2019","journal-title":"Tijdschr Psychiatr"},{"key":"key20260908110819_B10","article-title":"National Monitor Ambulatory Care and Long-Term MHC reforms \u2013 2020 [Dutch]","volume":"158","year":"2021"},{"key":"key20260908110819_B11","first-page":"203","article-title":"From assertive outreach to assertive treatment as a standard in mental healthcare [Dutch]","volume":"63","year":"2021","journal-title":"Tijdschr Psychiatr"},{"key":"key20260908110819_B12","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1111\/1467-9566.13346","article-title":"Frying eggs or making a treatment plan? Frictions between different modes of caring in a community mental health team","volume":"43","year":"2021","journal-title":"Sociol Health Illn"},{"key":"key20260908110819_B13","first-page":"298","article-title":"Flexible assertive community treatment (FACT) as part of a community (health) network","volume":"62","year":"2020","journal-title":"Tijdschift Voor Psychiatrie"},{"key":"key20260908110819_B14","author":"World Health Organization","journal-title":"Guidance on community mental health services \u2013 Promoting person-centred and rights-based approaches"},{"key":"key20260908110819_B15","article-title":"MHC Untangled. Exploration of Possiblilities and Problems of the current Reform Narrative [Dutch report]","year":"2023"},{"key":"key20260908110819_B16","article-title":"Flexible assertive community treatment teams can change complex and fragmented service systems: experiences of service providers","volume":"15","year":"2021","journal-title":"Int J Ment Health Syst"},{"key":"key20260908110819_B17","article-title":"NAPHA \u2013 FACT Model Description [Norwegian]","author":"Akerholt","year":"2025"},{"key":"key20260908110819_B18","article-title":"Integration of Care in Complex and Fragmented Service Systems: Experiences of Staff in Flexible Assertive Community Treatment Teams","volume":"22","year":"2022","journal-title":"Int J Integr Care"},{"key":"key20260908110819_B19","article-title":"Flexible Assertive Community Treatment in Rural and Remote Areas: A Qualitative Study of the Challenges and Adaptations of the Model","volume":"10","year":"2022","journal-title":"Front Public Health"},{"key":"key20260908110819_B20","first-page":"1","article-title":"(Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol","volume":"22","year":"2022","journal-title":"BMC Psychiatry"},{"key":"key20260908110819_B21","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1177\/1524839904273387","article-title":"Developing a Process-Evaluation Plan for Assessing Health Promotion Program Implementation: A How-To Guide","volume":"6","year":"2005","journal-title":"Health Promot Pract"},{"key":"key20260908110819_B22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","year":"2007","journal-title":"International Journal for Quality in Health Care"},{"key":"key20260908110819_B23","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1080\/00207411.2017.1345041","article-title":"What matters when implementing Flexible Assertive Community Treatment in a Swedish healthcare context: A two-year implementation study","volume":"46","year":"2017","journal-title":"Int J Ment Health"},{"key":"key20260908110819_B24","article-title":"A Qualitative Study on the Implementation of Flexible Assertive Community Treatment \u2013 an Integrated Community-based Treatment Model for Patients with Severe Mental Illness","volume":"21","year":"2021","journal-title":"Int J Integr Care"},{"key":"key20260908110819_B25","article-title":"Community mental health service: an experience from East Lille, France","volume":"19","year":"2014","journal-title":"Journal of Mental Health and Human Behaviour"},{"key":"key20260908110819_B26","author":"Landheim A (Norway), Rosenquist A (Denmark)"},{"key":"#cr-split#-key20260908110819_B27.1","unstructured":"Norwegian Ministry of Health and Care Services. Nasjonal helse- og sykehusplan 2020-2023. 2019"},{"key":"#cr-split#-key20260908110819_B27.2","unstructured":"n.d. https:\/\/www.regjeringen.no\/no\/dokumenter\/nasjonal-helse--og-sykehusplan-2020-2023\/id2679013\/ (accessed October 14, 2024)."},{"key":"key20260908110819_B28","first-page":"1261","article-title":"Tackling social inequalities in health: Assessing contexts for implementing integrated health access for people with severe mental illness","volume":"39","year":"2024","journal-title":"International Journal of Health Planning and Management"},{"key":"key20260908110819_B29","first-page":"1","article-title":"Embracing the Social Nature of Recovery: A Qualitative Study on the Resource Group Method for People With Severe Mental Illness","volume":"11","year":"2020","journal-title":"Front Psychiatry"},{"key":"key20260908110819_B30","article-title":"Place-Based FACT: Treatment Outcomes and Patients\u2019 Experience with Integrated Neighborhood-Based Care","year":"2024","journal-title":"Community Ment Health J"},{"key":"key20260908110819_B31","first-page":"1","article-title":"A pre-post study design: evaluating the effectiveness of a new community-based integrated service model on patient outcomes","volume":"18","year":"2024","journal-title":"Int J Ment Health Syst"},{"key":"key20260908110819_B32","first-page":"1","article-title":"Recovery for all in the community; Position paper on principles and key elements of community-based mental health care","volume":"19","year":"2019","journal-title":"BMC Psychiatry"},{"key":"key20260908110819_B33","article-title":"More that unites us than divides us? A qualitative study of integration of community health and social care services","volume":"21","year":"2020","journal-title":"BMC Fam Pract"},{"key":"key20260908110819_B34","article-title":"Shared leadership in healthcare [Dutch Article]"},{"key":"key20260908110819_B35","year":"2015"}],"container-title":["International Journal of Integrated Care"],"original-title":[],"link":[{"URL":"https:\/\/ijic.org\/articles\/9794\/files\/6a9fecb6aeb2c.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ijic.org\/articles\/9794\/files\/6a9fec9ac52d0.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ijic.org\/articles\/9794\/files\/6aa001a6cf54b.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:51:49Z","timestamp":1788871909000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijic.org\/articles\/10.5334\/ijic.9794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":36,"URL":"https:\/\/doi.org\/10.5334\/ijic.9794","relation":{},"ISSN":["1568-4156"],"issn-type":[{"value":"1568-4156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]}}}