The Integration of Flexible Assertive Community Treatment with District Social Support Service Teams for Patients with Severe Mental Illness in the Netherlands: A Qualitative Analysis of Team Members’ Experiences
References
- Schinnar AP, Rothbard AB, Kanter R, Jung YS. An empirical literature review of definitions of severe and persistent mental illness. American Journal of Psychiatry. 1990;147:1602–1608. DOI: 10.1176/ajp.147.12.1602
- Slade M, Williams J, Bird V, Leamy M, Le Boutillier C. Recovery grows up. Journal of Mental Health. 2012;21:99–103. DOI: 10.3109/09638237.2012.670888
- Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. British Journal of Psychiatry. 2011;199:445–452. DOI: 10.1192/bjp.bp.110.083733
- van der Stel J. Functioneel herstel en zelfregulatie: opgaven voor cliënten én psychiaters. Tijdschift Voor Psychiatrie. 2015;57:815–822.
- Vogel S. Facilitating recovery in people with psychosis. Groningen: University of Groningen; 2022. DOI: 10.33612/diss.217103261
- Westen K. Does FACT have a Future? n.d.
- van Veldhuizen JR. FACT: A Dutch Version of ACT. Community Mental Health Journal. 2007;43(4):421–433. DOI: 10.1007/s10597-007-9089-4
- Westen K, Vugt van M, Bähler M, Kroon H, Delespaul P. FACT Scale version 2017-R; 2022.
- Westen KH, Van Vugt MD, Bähler M, Delespaul PH, Kroon H. Development of the updated Flexible ACT-scale: F-ACT-s 2017 [Dutch article]. Tijdschr Psychiatr. 2019;97.
- Kroon H, Knispel A, Hulsbosch L, de Lange A. National Monitor Ambulatory Care and Long-Term MHC reforms – 2020 [Dutch] 2021;158.
- Mulder CL, Liégeois A, Vugt M van, Westen K, Delespaul PH, Kroon H. From assertive outreach to assertive treatment as a standard in mental healthcare [Dutch]. Tijdschr Psychiatr. 2021;63:203–208.
- Muusse C, Kroon H, Mulder CL, Pols J. Frying eggs or making a treatment plan? Frictions between different modes of caring in a community mental health team. Sociol Health Illn. 2021;43:1581–1597. DOI: 10.1111/1467-9566.13346
- Westen K, Vugt V, Bähler M, Mulder C, Delespaul P, Kroon H. Flexible assertive community treatment (FACT) as part of a community (health) network. Tijdschift Voor Psychiatrie. 2020;62:298–303.
- World Health Organization. Guidance on community mental health services – Promoting person-centred and rights-based approaches; n.d.
- Boumans J, Kroon H, van der Hoek B. MHC Untangled. Exploration of Possiblilities and Problems of the current Reform Narrative [Dutch report]; 2023.
- Trane K, Aasbrenn K, Rønningen M, Odden S, Lexén A, Landheim A. Flexible assertive community treatment teams can change complex and fragmented service systems: experiences of service providers. Int J Ment Health Syst. 2021;15:
38 . DOI: 10.1186/s13033-021-00463-1 - Akerholt. NAPHA – FACT Model Description [Norwegian]; 2025.
- Trane K, Aasbrenn K, Rønningen M, Odden S, Lexén A, Landheim A. Integration of Care in Complex and Fragmented Service Systems: Experiences of Staff in Flexible Assertive Community Treatment Teams. Int J Integr Care. 2022;22. DOI: 10.5334/ijic.6011
- Trane K, Aasbrenn K, Rønningen M, Odden S, Lexén A, Landheim AS. Flexible Assertive Community Treatment in Rural and Remote Areas: A Qualitative Study of the Challenges and Adaptations of the Model. Front Public Health. 2022;10:
913159 . DOI: 10.3389/fpubh.2022.913159 - Kleijburg A, Wijnen B, Evers SMAA, Kroon H, Lokkerbol J. (Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol. BMC Psychiatry. 2022;22:1–11. DOI: 10.1186/s12888-022-04346-8
- Saunders RP, Evans MH, Joshi P. Developing a Process-Evaluation Plan for Assessing Health Promotion Program Implementation: A How-To Guide. Health Promot Pract. 2005;6:134–147. DOI: 10.1177/1524839904273387
- Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19:349–357. DOI: 10.1093/intqhc/mzm042
- Svensson B, Hansson L, Markström U, Lexén A, International S, Health M. What matters when implementing Flexible Assertive Community Treatment in a Swedish healthcare context: A two-year implementation study. Int J Ment Health. 2017;46:284–298. DOI: 10.1080/00207411.2017.1345041
- Nielsen CM, Hjorthøj C, Nordentoft M, Christensen U. A Qualitative Study on the Implementation of Flexible Assertive Community Treatment – an Integrated Community-based Treatment Model for Patients with Severe Mental Illness. Int J Integr Care. 2021;21:
13 . DOI: 10.5334/ijic.5540 - Kishore J, Roelandt J, Bastow P, Caria A, Daumerie N, Defromont L. Community mental health service: an experience from East Lille, France. Journal of Mental Health and Human Behaviour. 2014;19:
10 . DOI: 10.4103/0971-8990.143884 - Landheim A (Norway), Rosenquist A (Denmark). Preliminary study results presented at the 6th European Conference on Integrated Care and Assertive Outreach, Leuven;
2023 . - Norwegian Ministry of Health and Care Services. Nasjonal helse- og sykehusplan 2020–2023. 2019; n.d.
https://www.regjeringen.no/no/dokumenter/nasjonal-helse--og-sykehusplan-2020-2023/id2679013/ (accessed October 14, 2024). - Mejsner SB, Bech M, Fehsenfeld M, Lundberg L, Westergaard CL, Vixø K, et al. Tackling social inequalities in health: Assessing contexts for implementing integrated health access for people with severe mental illness. International Journal of Health Planning and Management. 2024;39:1261–1276. DOI: 10.1002/hpm.3798
- Tjaden CD, Boumans J, Mulder CL, Kroon H. Embracing the Social Nature of Recovery: A Qualitative Study on the Resource Group Method for People With Severe Mental Illness. Front Psychiatry. 2020;11:1–11. DOI: 10.3389/fpsyt.2020.574256
- van Ens W, Sanches S, Beverloo L, Swildens WE. Place-Based FACT: Treatment Outcomes and Patients’ Experience with Integrated Neighborhood-Based Care. Community Ment Health J. 2024. DOI: 10.1007/s10597-024-01277-4
- Engelsbel F, Keet R, Nugter A. A pre-post study design: evaluating the effectiveness of a new community-based integrated service model on patient outcomes. Int J Ment Health Syst. 2024;18:1–11. DOI: 10.1186/s13033-024-00636-8
- Keet R, De Vetten-Mc Mahon M, Shields-Zeeman L, Ruud T, Van Weeghel J, Bahler M, et al. Recovery for all in the community; Position paper on principles and key elements of community-based mental health care. BMC Psychiatry. 2019;19:1–11. DOI: 10.1186/s12888-019-2162-z
- Mitchell C, Tazzyman A, Howard SJ, Hodgson D. More that unites us than divides us? A qualitative study of integration of community health and social care services. BMC Fam Pract. 2020;21. DOI: 10.1186/s12875-020-01168-z
- Van Der Scheer W. Shared leadership in healthcare [Dutch Article]; n.d.
- Wilken J-P.
Re-professionalisation: Reform of long-term care [Dutch article] . Maatwerk – Vakblad Voor Maatschappelijk Werk; 2015.
DOI: https://doi.org/10.5334/ijic.9794 | Journal eISSN: 1568-4156
Language: English
Page range: 16 - 16
Submitted on: Apr 3, 2025
Accepted on: Jul 2, 2026
Published on: Sep 8, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Keywords:
© 2026 Anne Kleijburg, Christien Muusse, Ben Wijnen, Joran Lokkerbol, Pim Candel, S. Kor Spoelstra, E. C. Marjolijne de Jong, Silvia Evers, Hans Kroon, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.