The Impact of the Covid-19 Pandemic on Assertive Community Treatment Team Functions, Clinical Services, and Observable Outcomes—A Provincial Survey in Ontario, Canada

Aly Kassam, Michaela Beder, John Maher, Saadia Sediqzadah, Nicole Kirwan, Madeleine Ritts, Matthew Levy, Samuel Law
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Abstract

Assertive Community Treatment (ACT) teams provide the most intensive care for patients with serious mental illness. This online study surveyed the 88 ACT and Flexible ACT (FACT) teams in Ontario, Canada (144/232 surveys, 62.1%) during the height of Covid-19 in 2021, and qualitative thematic analysis on impact of team function and patient outcome showed challenges of teams switching to virtual care, reduced psychosocial services, division to smaller groups, staff redeployment, having unequal compensations, and exacerbated regional differences; there were also increased patient stress, loneliness, hospital and ER visits, substance use and related deaths, and police/crisis team involvement. There was limited morbidity related to actual Covid-19; and positive adaptations included observed independence and resilience, increased interdependence with community partners, and new communication formats.
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2019冠状病毒病大流行对自信社区治疗团队功能、临床服务和可观察结果的影响——加拿大安大略省的一项省级调查
果断的社区治疗(ACT)小组为患有严重精神疾病的患者提供最深入的护理。这项在线研究调查了加拿大安大略省在2021年Covid-19高峰期的88个ACT和Flexible ACT (FACT)团队(144/232次调查,占62.1%),对团队功能和患者结果影响的定性专题分析显示,团队转向虚拟护理、心理社会服务减少、小组划分、人员重新部署、薪酬不平等以及地区差异加剧等挑战;病人的压力、孤独感、去医院和急诊室就诊、药物使用和相关死亡,以及警察/危机处理小组的参与也有所增加。与实际Covid-19相关的发病率有限;积极的适应包括观察到的独立性和复原力,与社区伙伴的相互依赖增加,以及新的沟通形式。
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