As part of the current restructuring of mental health services, the closure of half of the psychiatric hospital beds in Quebec is now underway. With this perspective, CETS decided to evaluate the relevance, for the Quebec health care system, of a significant model of community care for those with severe and persistent mental illness in most need: namely, the Assertive Community Treatment model, ACT. This report first examines published studies on this intensive case management model with respect to its effects on quality of services and its efficiency. The report also evaluates to what extent the model is applicable to the Quebec context, notably by identifying two local programs and appraising their degree of faithfulness to the ACT model and their net impact on direct costs. Finally, the report puts forward certain measures to facilitate the implementation of this approach in Quebec.

"This toolkit is designed for program evaluators and others who wish to understand how unit costs of specific mental health services are estimated, especially where data available to carry out estimations vary in both quantity and quality"--Introduction.