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| Author and year | Country; context | Description of service | Users and/or provider characteristics | Diagnosis | SRQR |
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| Half-way houses |
| (1) McKenna et al. (2016) | Australia; Melbourne, Victoria | Each of the 12 units are equipped with a communal kitchen and lounge area and shared bathroom and laundry facilities. There are designated spaces for gym equipment, separate male and female living areas, a sensory modulation room, and a communal recreation room with Internet access that also allows a location for various group activities. The CCU also has several court yards for outdoor recreation and quiet spaces including a vegetable garden, which the consumers assist to maintain. The CCU is staffed with 20 employees across the multidisciplinary spectrum. The service provides treatment, supervision, support, and life skills for those whose needs cannot be met adequately by other available programs and services. The average length of stay of consumers is 16 months | Seven current consumers; the consumers had been at the CCU for between 12 months and 2 years. 11 Staff from the following disciplines: 3 informal carers, a manager, a medical doctor, six registered nurses, and three allied health workers (a SW, an OC, and a psychologist). The staff had been at the CCU for between 6 months and 15 years | Unremitting and severe symptoms of mental illness | 19 |
| (2) Gyamfi et al. (2020) | Ghana; Kumasi Metropolis and Ejisu-Juabe municipality, both in the Ashante region | Shared model of service delivery, which aim to reintegrate adult consumers of mental health services into their communities. Shared halls and rooms for living, care is recovery oriented, strength-based, designated rehabilitation focus, voluntary engagement in rehabilitation, individualized care planning, transitional support, role of peer support. Treatment and support include cognitive behavioral therapy, living skills support and development, structured leisure and physical activities, social integration and economic empowerment, and evidence-based therapeutic group programs | Users were 19, 11 were males and 8 were females. Age group ranged from 20 to 70. For providers, 2 were OT, 1 was a psychiatric nurse, 1 was a psychiatrist/prescriber, 1 was a SW, 3 were males and 2 were females, 3 were single, and 2 were married. Their average years of working experience was 3 years | Psychotic or severe conditions, such as schizophrenia, depression, bipolar, and drug addiction | 21 |
| (3) Parker et al. (2017) | Brisbane Australia | The CCU provides 24-hour care around living skills and community integration, with opportunities for engagement in evidence-based therapies. The aim is to support consumers with severe and persisting mental illness to achieve personal recovery through recovery-oriented rehabilitation care over a 6–24 month period | Participants had worked at the site for an average of 2.6 years (range: 1.4–3.5 years). Seven participants had worked in other mental health settings; none had worked at different CCU. A range of junior and senior roles were represented including nursing (n = 5), allied health (n = 2), and nonclinical support (n = 1). Five female and three male staff members were interviewed | Severe and persisting mental illness | 20 |
| (4) Gamaldien et al. (2021) | South Africa | The Gateway was one of two 40-bed step-downs/step-up residential-based rehabilitation facilities, the services are headed by a social worker and staffed by a multiprofessional psychiatric team, offered a group-based weekly programme consisting of 14 group activities and eight themed projects addressing topics such as psychoeducation, treatment adherence, self-care, activities of daily living, creative exploration, and social integration skills | 5 men aged between 27 and 55 years, 3 were colored, 1 black, and 1 white. Admissions were from 2010 to 2012 | Schizophrenia, bipolar affective disorder, and schizoaffective disorder | 20 |
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| Supported housing |
| (1) Saavedra et al. (2012) | Spain | The special CHs are residences, housing between 15 and 20 people, with 24 h, nonclinical, professional support. Care homes are defined as social resources and are designed for severe mental patients. The care home is a setting where residents’ day-to-day routines are supervised by staff living with them in the same areas | On average, the carers in the sample had worked at the care homes for 7.4 years. The group consisted of three men and seven women. The average age was 39.75, range 27–48. Four of the participants had university backgrounds, with two psychologists and two trainee social educators | Schizophrenia, schizotypal, or delirious idea disorders, with 91.7% receiving medical treatment and 38.1% psychosocial treatment | 18 |
| (2) Wilton (2004) | Hamilton, Ontario | Residential care facilities provide accommodation for more than 700 people with SMI. Facilities are privately owned and have been an important source of accommodation since the 1970s. Operators are paid by municipal and provincial governments to provide food, shelter, and basic care/rehabilitation | Twenty-two people participated in the study. They ranged in age from 23 to 57, with an average age of approximately 38 years | SMI, most commonly schizophrenia | 18 |
| (3) Robison et al. (2018) | Canada | Assisted living facilities provide support for daily living to residents who cannot live independently. Supportive services include meals, laundry, and housekeeping, as well as assistance with grooming, hygiene, and medication administration; more than one half of these facilities provide supervised housing to individuals with mental illness | Seven males and one female between ages 60 and 68 volunteered to participate. Years of residing ranged between 2 and 34 years | Schizophrenia | 20 |
| (4) Low et al. (2019) | Malaysia. Perak | Community-based rehabilitation services that provides long-term accommodation and opportunities for PLSMI to continue living in community instead of being institutionalized. They had untrained caregivers proving care | 8 participants, with ages that ranged from 30 to 45 years, and they had lived in the center for between 5 and 8 years. The participants were two Indians, two Malays, and four Chinese | SMI | 21 |
| (5) D’Souza et al. (2021) | India | The facility services include helping clients develop a sense of independence, catering to their individual needs, offering a homely atmosphere where they participate in in-house activities, and providing a sense of community living facility has provided accommodation for clients who can live independently with mental health workers’ support. The 24/7 staff team includes five professional staff, four support staff, and one watch man. Each professional staff is assigned a few clients so that time and quality care can be given to them | Family care givers of 16 clients currently living at facility | 13 clients are diagnosed with schizophrenia, 1 with bipolar affective disorder, 1 with schizoaffective disorder, and 1 with mood disorder due to brain injury | 16 |
| (6) Drake (2014) | Sydney | Supervised accommodation characterized by congregate living, which can include dormitory-style rooms. Some also provide additional services including meals, general cleaning, and clothes laundering. Users are segregated and isolated, with untrained people to manage those with SMI. They use bells and whistles to manage behavior, food only accessed at scheduled time and locked kitchens | Seven current residents and 3 people who had left a licensed boarding house participated in an unstructured interview. 15 staff from community organizations, 12 from government agencies, and 3 proprietors of licensed boarding houses | SMI and intellectual disability | 18 |
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| Independent living units |
| (1) Carpeter-Song et al. (2012) | USA, Washington DC | SH units that embody the structure and philosophy of “supported independent living.” Each recovery community (RC) is assigned two case managers, who together comprise the recovery team at the agency. Case managers do not reside in the RCs; rather, services are provided through regular visits to the RCs. RC residents maintain strong ties to the agency through the recovery team, while at the same time are responsible for the upkeep of their own apartments and are independent in their daily routines | Most residents of the RCs are female (75%) and identify as African American (83%); the average age of residents is 47.11 years | SMI: many of whom have co-occurring substance use disorders, histories of trauma and homelessness and involvement in the criminal justice system | 17 |
| (2) Piat et al. (2020) | Canada, cities (Toronto: 29 single units), (Montreal: 35 units), (Qubec city: 2 sites housing 45 and 182 single units) and St John’s Newfoundland with 100 single units | Residents sign a lease guaranteeing full tenancy rights; lack of activity restrictions; rent limited to 30% of income; optional support services unlinked with housing eligibility; and the option to intensify services without risk to housing tenure. The Montreal and Toronto sites provide congregate housing, while the two Quebec sites and the St. John’s site offer scattered-site housing. Montreal and Toronto have staff available onsite, moderate level of support and their emphasis on move on is limited. 2 Quebec city have no staff on-site, low support and limited emphasis on move on. Lastly, St. John’s has onsite and no staff onsite, moderate support, limited emphasis on move on | 24 tenants agreed to be interviewed; the mean age was 46, 18 were males, 6 were females, 1 was from Haiti, 1 from Mexico, 22 from Canada | Psychotic disorder, mood disorder, anxiety disorder, obsessive/compulsive disorder, and addiction | 21 |
| (3) Tsai et al. (2010) | Chicago | Residential continuum gradually transitions individual to community living through placements in progressively less restrictive and less intensively staffed housing arrangements. The area consists of security, staff offices, and common spaces at the street level. They have private bath, fully equipped kitchen, furniture, and linens. Many residents lack fully developed independent living skills needed to maintain an apartment so they highly supervised. Those in independent housing live independent in the community throughout the city but they receive comprehensive case management services. Independent housing, they have own apartments and/or single room occupancies and keys, own bathroom, and kitchen for cooking | Twenty clients in supervised housing were randomly selected (10 clients from each residential program) and all clients approached agreed to participate | SMI (schizophrenia-spectrum disorder, bipolar disorder, and major depressive disorder) and a substance use disorder (any substance dependence or abuse diagnosis) | 18 |
| (4) Petersen et al. (2015) | Danish, Denmark | Person-centered, focusing on user involvement, self-determination, and hope, and supporting each person in his/her individual recovery process. Mental health services in the municipality encompass outreach work, day-care services, special education, and home support. Approximately 15–20 people live in each unit, in two-room apartments with a bathroom and a kitchenette. Staff works 37 h per week, and they are recruited from a range of professional backgrounds: social workers, social and health care assistants, nurses, and occupational therapists. Staff help residents with the preparation of meals, laundry, cleaning, arranging trips, and social activities. The main entrances to the apartments open into shared corridors, where common rooms are available for watching TV and cooking meals | 12 service users who had been living in three different SH services for between 6 months and 5 years. The sample included 6 women and 6 men aged 21–57 with a mean age of 35 | Schizophrenia and bipolar disorder | 19 |
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| (5) Eirik et al. (2016) | Norway, Trondheim, city in central | The sheltered houses are organized as units consisting of one building complex with 7–30 one-person fully equipped apartments with all amenities such as their own bathroom, kitchen, and living room and access to a shared accommodation room. The residents are offered a 3-year tenancy agreement which must be renewed at the end of the term. Live-in staff (employed by the municipality) attended each unit 24 h a day, 7 days a week (24/7). The main purpose of these facilities is to maximize the personal autonomy of residents and encourage them to do as much as possible for themselves including personal care, shopping, cooking, domestic chores, and leisure time activities with the support of the staff as needed. Most residents have daily or weekly meetings with a mental health nurse or a service provider to discuss topics such as how to cope with the psychiatric disease, somatic health, household tasks, and financial issues. All services offered are voluntary, meaning that users can decide whether they want to accept help or not | A total of 14 participants (8 men and 6 women). They had lived in the current unit from 2 months to 12 years and none were employed | SMI | 21 |
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| (6) Shepherd et al. (2019) | Queensland Australia | Support people with mental illness who were at risk of homelessness and self-neglect. Care for clients was provided by staff from three government departments and an NGO. Department of Housing provided a permanent home for the person support workers assist with a range of practical task such as assistance with shopping; supporting participation in community activities; providing social and emotional help; and maintenance of physical health, such as monitoring compliance with medication and encouraging a healthy lifestyle | 27 support workers and 10 managers from 20 services across Queensland (9 metropolitan and 11 regional) | SMI | 19 |
| (7) Ericsson et al. (2016) | Sweden | Support in everyday life involving the content of their assignment; (ii) the inside and outside of the home i.e., the arena; (iii) relationship aspects, i.e., the interaction between the user and the HSW. These are obligations that the HSW is supposed to relate to in everyday work | Twenty-five people were included, twenty-two were women and three were men. All twenty-five employees worked at private housing | SMI | 16 |
| (8) Deane et al. (2012) | Australia, Southeast Allawarra and Sydney areas | The most common type of accommodation provided was that of a bedroom, shared cooking facilities, and shared bathroom. However, a minority provided residents with their own bathroom and kitchenette. A very small minority provided part board (one meal per day) or full board (three meals per day) | Participants were 23 boarding house manager and owners, from both the Illawarra (N07) and Sydney city and Inner West areas (N016). Of these participants, 74% (N017) were male and 26% (N06) were female | Schizophrenia, depression, marijuana, and alcohol | 17 |
| (9) Lindvig et al. (2021) | Norway | Colocated (fully equipped) apartments with staff onsite either during the day only or both day and night and high support, with various levels of emphasis on moving out | 5 females and 4 male staff, representing both mental health nurses, SW, and other professions within the interdisciplinary context of community mental health | SMI and/or drug addiction | 21 |
| (10) Walker and Seasons (2009) | Canada, Southwestern Ontario, within catchment area of the Waterloo Region | Involves normal, integrated housing that is adequate and affordable, paired with flexible and individualized mental health support services. This model focuses on person-centered support, self-help and natural supports and de-emphasizes the role of professional services. People are empowered to choose, get, and keep the housing and support services they want and thus are able to experience their residence as a home rather than as housing | 14 single men, 14 single women, and 3 couples. The age of participants ranged from 22 to 56, with an average age of 41 years (SD = 9.60) | SMI | 18 |
| (11) Sandhu et al. (2017) | England | Residential care homes are staffed 24 h a day, seven days a week, with a high level of support provided, including meals, cleaning, personal care, and supervision with medication. Clients share communal facilities and placements tend not to be time limited although clients can be supported to transition to more independent settings. SH services can be provided as shared or individual tenancies with staff onsite available most of the day (up to 24 h). Placements are usually time limited, with services supporting clients to gain skills needed to move to a more independent living situation. Floating outreach services provide staff visiting clients living in time-unlimited independent tenancies. Staff support clients emotionally and assist them to take on more and more responsibility to manage practical tasks (shopping, cooking, cleaning, budgeting, etc.), with the aim of being able to reduce and stop visiting staff support over time to gain skills needed to move to a more independent living situation | Residential care mean age was 45.4, SH mean age was 33.8, and floating outreach mean age was 39.8. 6 males were from residential care, 5 males were from SH, and 6 were from floating outreach. Females (4 were from residential, 5 from SH, and 4 from floating outreach). Mean years in current accommodation (3.7 residential care, 4.2 SH, and 2.1 floating outreach). Mean age (52 from residential care, 39.5 from SH, and 43.6 from floating outreach). Males (5 residential care, 2 SH, and 5 floating outreach) Females (5 residential care, 8 SH, and 5 floating outreach). Manager/deputy manager (5 residential care, 3 SH, and 4 floating outreach) and support worker (5 residential care, 7 SH, and 6 floating outreach). Mean years of working (8.2 residential care, 6.3 SH, and 4.9 floating) | Complex SMI problems | 21 |
| (12) Padmakar et al. (2020) | South India | SH provides structured, noninstitutional, and independent living arrangements along with supportive services aimed at providing medical attention, rehabilitation, and the attainment of life skills. Focuses on functioning impairment, social relationships, daily living skills, and to promote recovery and self-reliance | 11 patients mean age was 56, ranged (3 were between 40 and 49), 4 were 50 and over, 4 were 60 and over, all were women. 14 members of staff involved in SH, including healthcare workers, community workers, case managers, project managers, and management members | Schizophrenia (7), psychosis (3), and mood disorder with psychotic symptoms (1) | 17 |
| (13) Lindström et al. (2011) | Northern Sweden | A self-contained apartment, voluntarily attending traditional home- and community-based rehabilitation guided by an occupational therapist (100%) and a social worker (50%), who were called coaches. There were also shared facilities, such as an “open” apartment that was available to all residents for socializing. Coaching and support were offered to both individuals and groups. The housing was designed to become a permanent housing solution, if so desired by the resident, with a gradually reduced amount of support and increased independence | Six residents (four male two female); their ages varied from 24 to 37 years | 5 have been diagnosed with schizophrenia, and one with borderline personality disorder | 18 |
| (14) Tiderington et al. (2020) | USA | Treatments first prioritize and assume a need for mental health and substance use treatment before living independently or being competitively employed. Housing first (HF), as the name implies, has reversed this approach by prioritizing immediate access to independent housing. HF reflects a different conceptual understanding of recovery from mental illness instead of matching step wise services to the degree to which one’s symptoms have resolved, recovery in HF is understood as an ongoing process in which people can have satisfying and contributing lives without a resolution of symptoms | Individuals who were over 21 years of age, Global assessment of functioning (GAF) score above 65, housing stability, absence of current substance use disorder, and one or more signs of recovery such as having a job, being involved in meaningful activities, taking active part in a social group, and/or having a stable partner | DSMIV axis I diagnosis of serious mental illness | 17 |
| (15) Patterson et al. (2015) | Canada | Participates were divided into high need and moderate need (based on the complexity and intensity of their needs). High needs were randomized into either housing first with assertive community treatment, wherein participates could choose from up to three market lease apartments or congregate housing with onsite support, wherein participants had their own room, and bathroom, but shared amenities, receive 3 meals a day, activity programming and various health/social service onsite OR treatment as usual which provided no additional housing or support services beyond what existed in the community. Moderate-need participants were randomized to one of the two (a) housing first with intensive case management (ICM) wherein participants could choose from up to three market lease apartments across various neighborhoods and services were provided by a team of case managers who connected participants to existing services; and (b) treatment as usual | At the baseline, the mean lifetime duration of homelessness was 6 years and 30% had completed high school. The most common mental disorders among the sample, based on the MINI, were substance dependence (67%), psychotic disorder (49%), and major depressive episode (49%). The age of the follow-up sample ranged from 21 to 66 years (M 43 years) and included 25 men (58%), 16 women (37%), and two (5%) transgendered individuals | Substance dependence (67%) psychotic disorder (49%) and major depressive episode (49%) | 19 |
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| (16) Stefancic et al. (2012) | New York City | Allow participants to receive treatment rather than serve their sentence in jail. While in the program, participants receive support services and must provide regular follow-ups to the courts who supervise their compliance with treatment and program requirements. Services vary greatly in the range and intensity; they can include case management, court advocacy, drug and psychiatry treatment, vocational training, and housing. Services are typically provided by multidisciplinary assertive community treatment teams that have been modified to integrate principles of client choice and recovery, or for those with more moderate needs, by intensive case management teams | The majority of participants were male (n = 14, 70%) and African American (n = 14, 70%); 5 were Hispanic; and 1 was Caucasian. Participants’ mean age was 37, ranging from 19 to 52. At the time of the study, participants had spent on average, just less than a year in the HF program, ranging from 2 to 25 months. Time in the ATI program also varied, with some participants having recently completed the program whereas others were still actively participating. All participants were part of the ATI program or conditional release upon entering the HF program | Axis I psychiatric disorder, three were dually diagnosed with an Axis II psychiatric disorder, and 70% of participants were diagnosed or entered mental health services prior to the age of 18. Diagnoses included schizoaffective disorder (20%), bipolar disorder (20%), major depression (20%), schizophrenia (15%), and anxiety disorders (15%; note: percentages add up to more than 100% as individuals were sometimes diagnosed with two disorders). Rates of co-occurring disorder were high, with 15 participants (75%) diagnosed with a substance use disorder, including half for polysubstance dependence | 19 |
| (17) Barrenger et al. (2015) | USA | ACT interdisciplinary teams share the caseload of 60–65 residents (staff-to-resident ratio of approximately 1 : 10), providing service coverage 7 days a week, 24 hours a day. Team members all perform core case management activities although some specialize in specific areas such as nursing, substance abuse, and vocational education | The two teams were composed of a team leader and six team members. Five of the 14 case managers had graduate degrees that included social work, nursing, and psychology and 8 had undergraduate level education | serious mental illness, often co-occurring substance use and are homeless | 17 |
| (18) Aubry et al. (2015) | Canada | The program has a housing coordinator who assist program participants with finding a housing, negotiating a lease with a landlord, moving into and adapting to new housing and mediating any difficulties with the landlord. Individualized support is made accessible and delivered by members of an ACT team | Ten of the landlords were property managers and 13 landlords owned the rental property. These landlords rented to tenants located in the tricity area (n = 17) and in the adjoining rural region (n = 6) | Severe and persisting mental illness | 19 |
| (19) Henwood et al. (2011) | New York City | Support services, usually in the form of ACT teams, are located offsite but are available on-call 24 h a day, 7 days a week and most services are provided in the consumer’s natural environment (e.g., apartment, workplace, and neighborhood). The service is time unlimited in that it is offered if a consumer needs that level of support | Total of 41 service providers from both housing first and treatment first. 20 were from housing first and 21 were from treatment first. From the housing first 9 were males and 11 were females, 12 were White, 5 were African American, 1 was Latino, and 2 were other. 6 had been employed for less than a year, 6 were employed between 1 and 3 years, and 8 had been employed for more than 3 years. 13 were graduates, 4 had bachelor, 2 had associate, and 1 had high school. 16 had previous experience with similar client population and 4 had no experience. For treatment first, 7 were males and 14 were females. 6 were White, 9 were African American, and 6 were Latino. 9 had worked for less than a year, 7 had been working for between 1 and 3 years, 5 had been working for more than 3 years. 7 were graduates, 9 had bachelor, and 5 had associate. 16 had previous experience with similar client population while 5 had no experience | DSM axis 1 psychiatric disorders and substance abuse | 19 |
| (20) Sharif et al. (2021) | Canada | ACT teams offer, among others, crisis assessment and intervention, assistance with symptom management and daily living, pharmacological and behavioral interventions, substance use treatments, relapse prevention, recovery, and social support services, as well as vocational housing services | Psychiatrists, nurses, social workers, peer support workers, and mental health workers | Persisting severe mental illness | 18 |
| (21) Henwood et al. (2014) | New York | Permanent housing could be congregate setting or independent apartment living. Treatment-first model services mean that temporary shelter is initially offered followed by transitional housing before permanent housing can be attained. Graduating through these stages of housing requires that individuals meet treatment goals that include prolonged abstinence | Housing first (9 males, 11 females, 12 White, 5 African American, 1 was Latino, 2 were other, 13 were graduates, 4 had bachelor, 2 associate, 1 high school, 6 had worked for less than a year, 6 had worked for 1–3 years, and 8 had worked for more than 3 years) treatment first (7 were males, 14 were females, 6 were whites, 9 were African American, 6 were latinos, 7 were graduates, 9 had bachelors, 5 associate, 9 had been working for 1 year, 7 had been working for 1–3 years, and 5 had been working for more than 3 years) | An axis I diagnoses of serious mental illness such as schizophrenia or bipolar disorder and a history of substance abuse | 18 |
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| Living independently |
| (1) Milbourn et al. (2014) | Australia, Bentley | Support provided to individuals with SMI labelled “hard to engage” in form of medication, and crisis management. They provide personal recovery services, peer support, and living skills programs | 3 women & 8 men, all unemployed aged 27–53 | Psychotic, schizophrenia, and schizoaffective | 20 |
| (2) Krupa et al. (2005) | Canada, Eastern Ontario | Provides comprehensive array of continuous treatment, rehabilitation, and support services to help individuals with SMI who are high service users adjust to community living (interventions related to management of medications, side effects, family support, nutrition, and physical health) | 52 participants with mean age of 46.6 years, equal number of males and females, length of time receiving ACT services was 60.57 months, with range from 4 to 132 | SMI | 16 |
| (3) Petersen et al. (2014) | Norway | Team-based, service-delivery model for providing comprehensive community-based treatment to clients with severe and persistent mental illnesses who did not benefit from traditional treatment (follow-up treatment and aid in practical matters and community engagement activities) | Eleven participants (nine men and two women) aged 27–63 years (mean, 39 years) were included in the study. The duration of ACT was 14–30 months (mean, 22 months) at the time of the first interview | Hebephrenic schizophrenia, paranoid schizophrenia, undeferential schizophrenia, residual schizophrenia, bipolar affective disorder, psychosis with delusions, paranoid psychosis/delusions, alcohol, cannabis, amphetamine, and prescription drugs | 21 |
| (4) Gandy-Guedes et al. (2018) | USA, Central Virginia | Individual-centered and self-contained mental health program that provides psychiatric treatment, rehabilitation, and support services to persons with SMI. The primary principles of programme of ACT guide a multidisciplinary team, comprised of SW, rehabilitation counsellors, nurses, and psychiatrists, which provides long-term, intensive services seven days a week, 24 hours a day. Services provided by programme of ACT teams cover a wide range of health- and psychosocial-related areas, including intake and ongoing assessment of needs, case management, vocational rehabilitation, financial and housing assistance, psychiatry, and linkages to medical-related services | 12 males, 5 females, 8 were African American or Black, 6 were Caucasian, 2 were American Indians, and 1 was Hispanic. Mean age was 42.5 | Schizophrenia or schizoaffective, bipolar disorder, depression or anxiety, substance use diagnosis (abuse or dependence, in remission) | 19 |
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| (5) Linz and Sturm (2016) | Northeast, United States | ACT help ACT clients build relationships between one another, and between ACT clients and nonmentally ill community volunteers within the context of recreational outings. Motivate clients towards recovery goals, help overcome stigma by teaching appropriate behaviors, and by building client self-esteem through supportive worker/clients’ relationships. Having groups and community-based activities to facilitate social integration, ACT Christmas. Community integration activities such as going local farmers’ market, local department stores, hair cutting schools, pleasurable excursions to the zoo, amusement parks, walking group for fitness, and restaurants. The ACT is tasked to provide vocational opportunities like finding employment and educational opportunities, arranging volunteer work, offering a vocational group | All the participants had at least 6 months experience as workers on an ACT team. Gender was reported as 46% male and 54% female. Regarding race, 46% were Caucasian, 42% were African American, 8% were Hispanic, and 4% were Asian American. Out of 24 participants, seven were nurses, and of the 16 individual interviews conducted, six were with nurses. Other disciplines consisted of three team leaders (master level social workers), two peer counsellors, three vocational specialists, two substance abuse specialists, six general caseworkers with degrees in SW, counselling, or psychology, and one program director | All the client’s fit ACT’s criteria which were having a diagnosis of SMI, frequent psychiatric hospitalizations, and nonresponse to traditional outpatient services | 18 |
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| (6) Hurley and O’Reilly (2017) | London, Ontario, Canada | Intensive mental health program currently available for people living with severe and persistent mental illness. ACT teams deliver services to clients living under varying conditions of adversity. Clinicians on these team’s pool interprofessional knowledge and share the responsibility for all clients on the team’s caseload. ACT teams strive to be innovative, flexible, and creative in working with clients to achieve the best recovery possible. Clients are usually referred to ACT teams because they have not fared well in traditional psychiatric services either due to lack of adherence or a lack of response to treatment. Consequently, ACT clinicians often must confront treatment nonadherence while attempting to foster a positive client response to service contact | The subjects had an average of 12 years working in mental health (range: 3–30) and an average of 8 years working on an ACT team (range: 1–16). There were 8 female and 7 male participants with an age range of 28–60. All the participants had experience working with clients on community treatment orders which accounted for between 15 and 30% of cases on the four teams, including SW, nurses, and OT | SMI | 17 |
| (7) Krupa et al. (2009) | South-eastern Ontario, Canada, | Provides continuous services to promote the community adjustment of persons with SMI and high service usage. Critical features of the model include (1) organizational elements such as team responsibility for individual care, shared caseloads, daily planning meetings, 24-hour availability, and a low staff-client ratio; (2) continuous and intensive services delivered primarily in community settings and focused on promoting community adjustment; and (3) a multidisciplinary team structure that involves all providers in direct clinical work, including generic community work and activities specific to the provider’s training and experience | Eighteen ACT staff participated in the interviews, representing a variety of professions including nursing, psychology, SW, and psychiatric rehabilitation | Person with SMI and high service usage | 13 |
| (8) Chen and Herman (2012) | New York city | Comprehensive, intensive, assertive outreach and treatment services delivered in the community by an interdisciplinary team. An ACT team typically maintains a 1-to-10 staff-to-client ratio and has no explicit time limit on the duration of treatment. They help improve psychosocial functioning and decrease caregivers’ burden | We recruited four ACT teams in New York City. Age ranged from 24 to 56 with mean age of 38.2. Females were 13, males were 11, 7 were Black, 1 was Hispanic, 13 were White, 3 were not identified, 1 had 2-year college, 6 had bachelor’s degree, 15 had master’s degree, 1 had M.D. Mean years of experience in mental health was 8.7 ranging from 0.4 to 23, 0 experience with current agency years mean was 3.7 with range between 0.02 and 9.9. Experience in current position mean was 3.0 ranging from 0.02 to 9.9 | SMI | 17 |
| (9) Appelbaum and Le Melle (2008) | New York, Manhattan | ACT members visit users at their house to remind them about their goals and give feedback, involve both family and friends. Help users develop treatment plan, do things on their own, frequent contact with patients, education about medication compliance, and give users food and clothes | Users had age mean was 41.2, 13 males and 8 females, 15 were African American, 1 was White, and 6 were Hispanic; years in ACT: they had mean age of 3.4. Providers had age mean was 38.2, 9 were males, 14 were females, 12 were African American, 6 were White, 5 were Hispanic, 1 was Asian, 1 was American Indian. Years in ACT had mean age of 3.0 | SMI, schizophrenia | 19 |
| (10) Matscheck et al. (2020) | Sweden 3 municipalities | Supported individual living focuses on the person’s needs to be able to live a normal life in the community and includes help in taking care of one’s home, but also developing social relationships, using other services available to all persons living in the community and other situations which occur in daily life | Users were 12 women and six men, ranging in age from 34 to 73 years. Providers included 13 support workers, nine women and four men, with experience ranging from several months to nearly 20 years | Prolonged SMI (usually at least 6 months), with no criteria for specific diagnosis or institutional history. This covers a wide range of diagnoses, most commonly psychosis related, bipolar or severe depression, and sometimes also neuropsychiatric diagnoses such as high functioning autism | 19 |
| (11) Asher et al. (2018) | Sodo district in the Gurage, zone of the Southern Nations, Nationalities, and Peoples’ Region of Ethiopia | CBR is a recovery-oriented, emphasizing hope, human rights, and the participants’ own goals. Intervention delivery was guided by the RISE manual | Ten people with schizophrenia and their families. Men 4 in first 2 months and 5 in 12 months, women 3 in first 2 months and 3 in 12 months, male caregivers 1 (2 months and 12 months), female caregivers 7 in 2 months and 6 in 12 months, CBR supervisors 2 in 2 months and 2 in 12 months. CBRWs 2 focus groups (n = 10), health officers 2 (2 months), community members (3 in 12 months) | Schizophrenia, schizoaffective disorder, or schizophreniform disorder | 18 |
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