Early tailored assertive community case management for hard-to-engage adolescents suffering from psychiatric disorders: an exploratory pilot study


  • Author contributions: VB, LH and JF were responsible for the study conception and design. VB and LH performed the data collection. JF and VB performed the data analysis. VB and JF were responsible for the drafting of the manuscript. LH, PF and NK made critical revisions to the paper for important intellectual content. LH provided administrative, technical and material support. LH and JF supervised the clinical work.

Corresponding author: Miss Vanessa Baier, Antenne d'Intervention dans le Milieu pour Adolescents (AIMA), Children and Adolescents Unit (SUPEA), 23a, avenue du Bugnon, CH-1011 Lausanne, Switzerland. Email: vanessa.baier@chuv.ch



The study aims to evaluate the effects of assertive community treatment (ACT) on the mental health and overall functioning of adolescents suffering from severe psychiatric disorders and who refuse any traditional child psychiatric care. There are a few studies evaluating the effects of ACT on a population of adolescents with psychiatric disorders. This short report highlights the impact of an ACT programme tailored to the needs of these patients, not only as an alternative to hospitalization, but also as a new form of intervention for patients that are difficult to engage.


The effect of ACT on 35 adolescents using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) as a measuring tool in pre- and post-intervention was evaluated.


The results show that the intervention was associated with a significant improvement on the HoNOSCA overall score, with the following items showing significant amelioration: hyperactivity/focus problems, non-organic somatic symptoms, emotional symptoms, scholastic/language skills, peer relationships, family relationships and school attendance.


ACT appears as a feasible intervention for hard-to-engage adolescents suffering from psychiatric disorders. The intervention seems to improve their mental health and functioning. This pilot study may serve as a basis to prepare a controlled study that will also take the costs of the intervention into account.