Suicidality in Seriously Mentally Ill Clients of Two Intensive Community Mental Health Programs
Bibliographic record
Abstract
The purpose of this study was to evaluate the effect of two intensive community mental health programs on the suicidality of clients with serious mental illness. Eighty individuals with severe and persistent mental illness were enrolled in this randomized controlled study comparing two models of intensive community support: Assertive Community Treatment (ACT) and Intensive Case Management (ICM). Suicidal ideation and behaviours were measured using the Modified Scale for Suicide Ideation. Study clients underwent comprehensive interviews at baseline and were reinterviewed 9 and 18 months later. The Dartmouth Assertive Community Treatment Scale (DACTS) instrument was used to gain more insight into the specific ACT and ICM program structures and characteristics that provide crisis support and suicide intervention. A chart review of 2 randomly chosen months of service looked at the on-call after-hours pager use of ACT program clients. The ACT intervention was effective in reducing suicidal ideation over 18 months. In addition, the prevalence of suicidal ideation was significantly lower at 18 months in ACT clients versus ICM clients. This is the first study to suggest that ACT may confer some additional benefit in terms of reduced suicidality in clients with severe and persistent mental illness.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".