Letters

To the Editor: I read with interest the article "Comparison of ACT and Standard Case Management for Delivering Integrated Treatment for Co-occurring Disorders" and noted the authors' conclusion that "Integrated treatment can be successfully delivered either by assertive community treatment or by standard clinical case management."

With so much interest in evidence-based practice, and with assertive community treatment (ACT) so often touted as the model of choice for treating people with severe and persistent mental illness, this study calls into question the fundamental assumption that what has worked before will work now. One tires of professionals everywhere blindly jumping on the evidence-based-practice bandwagon. The self-congratulatory literature expounding the virtues of this or that evidence-based practice tends to do little more then champion a record of the past, limiting creativity and discouraging attempts to try something new that may in fact be better.

ACT was developed more than 20 years ago, and much has changed since then. Perhaps it is finally time to let go of what may be an antiquated and obsolete model and focus on outcomes instead of process.