Flexible assertive community treatment for individuals with a mild intellectual disability or borderline intellectual functioning: results of a longitudinal study in the Netherlands

• Published in: Journal of intellectual disability research Vol. 63; no. 8; pp. 1015 - 1022
• Main Authors: Neijmeijer, L. J., Korzilius, H. P. L. M., Kroon, H., Nijman, H. L. I., Didden, R.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.08.2019; John Wiley and Sons Inc
• Subjects: Adolescent; Adult; Assertive community treatment; Assertiveness; Behavior disorders; Behavior problems; borderline intellectual functioning (BIF); challenging behaviour; Client satisfaction; Clinical outcomes; Community; Community Mental Health Services - methods; Criminal justice; Criminality; Economic problems; Female; flexible assertive community treatment (FACT); Health behavior; Health care; Health services; Humans; Insight; Intellectual disabilities; Intellectual Disability - rehabilitation; Intellectual functioning; Learning disabilities; Learning disabled people; Longitudinal Studies; longitudinal study design; Male; Mental disorders; Mental health; mental health problems; Mental health services; Middle Aged; Mild Intellectual Disability; mild intellectual disability (MID); Netherlands; Original Manuscripts; Outcome and Process Assessment, Health Care; Police; Psychological functioning; Risk factors; Severity of Illness Index; Social justice; Social participation; Substance abuse; treatment results; Young Adult; Netherlands; borderline intellectual functioning (BIF); treatment results; challenging behaviour; flexible assertive community treatment (FACT); mental health problems; mild intellectual disability (MID); longitudinal study design
• ISSN: 0964-2633; 1365-2788
• DOI: 10.1111/jir.12619

Background Assertive community treatment (ACT) and Flexible assertive community treatment (FACT) are organisation models for intensive assertive outreach that were originally developed for individuals with severe mental illness. The models are increasingly applied to people with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and challenging behaviour or mental illness. Research on these types of care for this population is limited. To gain experience in FACT MID/BIF in the Netherlands and to obtain insight in its outcomes, four organisations specialised in the treatment of individuals with MID/BIF and challenging behaviour participated in a 6‐year implementation and research project. Methods A longitudinal study was set up to investigate outcomes over time. Outcome measures concerned admissions to (mental) health care, social and psychological functioning, (risk of) challenging and criminal behaviour, social participation and client satisfaction. Data were analysed using descriptive statistics and linear mixed models. Results Over time, clients showed improvement in their social and psychiatric functioning and living circumstances. The number of admissions to (mental) health care diminished as well as the number of contacts with police and justice, the level of social disturbance and the risk factors for challenging and criminal behaviour. Problems related to finances, work and substance abuse remained unchanged. Conclusions The results are encouraging and give rise to continued development of and broader research on FACT MID/BIF.