It is estimated that as many as 3 million Americans suffer from problems related to the mental illness schizophrenia. The illness, which produces devastating symptoms such as hallucinations, delusions, and disorganized thinking, chooses its victims from America's youth, often striking persons in their late teens and early twenties. Of all mental disorders labeled major mental illness, schizophrenia is considered the most disabling, affecting individual functioning and ability to live and work independently.

This study evaluates the Texas Department of Mental Health and Mental Retardation's (TXMHMR) Assertive Community Treatment (ACT) program's effectiveness in reducing state hospital use for program participants diagnosed with schizophrenia. The study uses archival records from TXMHMR's state management information system, to investigate the relationship between ACT and hospital use reduction. The researcher compares ACT participant use to the hospital use of a comparison group receiving another service (supported housing) during the same time period. The study also attempts to use state management information to investigate whether ACT clients experience an overall reduction in symptoms related to mental illness and improved community functioning as indicated on assessment tools required by the state.

A quasi-experimental, post-test only, comparison group design is used to test hypotheses concerning how ACT influences hospital use, psychiatric symptoms and community functioning. The study was large (702 experimental group and 902 comparison group). Hypotheses were tested using t-tests. The results show TXMHMR's decision to implement assertive community treatment in relation to improving services targeted to persons with the most severe impairments related to mental illness appears to have been a wise one. Texas' assertive community treatment program is successful in meeting one of its primary goals: to assist individuals with severe mental illness in reducing dependency on state hospital inpatient care.

The use of TXMHMR's statewide management information data in program evaluation is another important aspect of this study. The Uniform Assessment data appears to have potential in ongoing program evaluation at both the state level and at the local service sites. While this study only analyzed a few variables, the Uniform Assessment data includes many more variables that can be analyzed in future studies using more sophisticated statistical analyses that were used in this study.