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Background: Assertive Community Treatment (ACT) is an evidence-based treatment program for people with severe mental illness developed in high-income countries. We report the first randomized controlled trial of ACT in mainland China., Methods: Sixty outpatients with schizophrenia with severe functional impairments or frequent hospitalizations were randomly assigned to ACT (n = 30) or standard community treatment (n = 30). The severity of symptoms and level of social functioning were assessed at baseline and every 3 months during the 1-year study. The primary outcome was the duration of hospital readmission. Secondary outcomes included a pre-post change in symptom severity, the rates of symptom relapse and gainful employment, social and occupational functioning, and quality of life of family caregivers., Results: Based on a modified intention-to-treat analysis, the outcomes for ACT were significantly better than those of standard community treatment. ACT patients were less likely to be readmitted [3.3% (1/30) v. 25.0% (7/28), Fisher's exact test p = 0.023], had a shorter mean readmission time [2.4 (13.3) v. 30.7 (66.9) days], were less likely to relapse [6.7% (2/30) v. 28.6% (8/28), Fisher's exact test p = 0.038], and had shorter mean time in relapse [3.5 (14.6) v. 34.4 (70.6) days]. The ACT group also had significantly longer times re-employed and greater symptomatic improvement and their caregivers experienced a greater improvement in their quality of life., Conclusion: Our results show that culturally adapted ACT is both feasible and effective for individuals with severe schizophrenia in urban China. Replication studies with larger samples and longer duration of follow up are warranted.

Objective: This study reports findings from a preliminary evaluation of the first implementation of the assertive community treatment (ACT) model in mainland China., Methods: Over six months, the pilot study compared a group of patients (N=15) and family caregivers who received ACT services with a control group (N=16) who received standard community services. Data on hospitalization days, relapse frequency, psychiatric symptoms, social and vocational functioning, general mental health status, family burden, and level of social support for family caregivers were examined., Results: ACT patients had no admissions, compared with two in the control group; they also had significantly lower psychopathology and higher social functioning scores. No significant differences in outcome measures for family caregivers were found., Conclusions: The study found preliminary support for implementing ACT in mainland China. Implementation could contribute to reducing admission and psychopathology and improving social functioning. Further research on ways to enhance family caregivers' experience is warranted.