Care models
Therapeutic Assertive Community Treatment (TACT)

The so-called “Hamburg Model” is an integrated mental health care model including Therapeutic Assertive Community Treatment (TACT) for adolescents and adults (12+ years) with severe mental illness (SMI). It offers integrated, long-term, intensive, and assertive treatment
to people with severe psychoses including schizophrenia spectrum disorders, bipolar disorders, and psychotic major depression and borderline personality disorder.

The model was first implemented in 2005 for severe psychoses, extended to first-episode psychosis aged 12 to 29 years in 2012 and to Borderline personality disorders in 2015. The model is financed per-patient annual rate by 19 health insurances.

University Medical Centre Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy

The so-called “Hamburg Model” is an integrated mental health care model including Therapeutic Assertive Community Treatment (TACT) for adolescents and adults (12+ years) with severe mental illness (SMI). It offers integrated, long-term, intensive and assertive treatment
to people with severe psychoses including schizophrenia spectrum disorders, bipolar disorders and psychotic major depression and borderline personality disorder.

The integrated care model currently consists of the following components:

Inpatient and day-clinic care units in adult and child- and youth psychiatry.
Disease-specific outpatient centres for psychoses, bipolar disorder, major depression, and personality disorders.
High fidelity TACT teams, each responsible for about 80-100 patients in a 1:15-1:25 clinicians-patient ratio with 24/365 emergency service. The TACT teams have extensive expertise and are multidisciplinary, including psychiatrists, psychologists, social workers and recovery companions. About 80% are psychiatrists and psychologists.
Within the sector, the model includes 24 registered specialists in psychiatry and psychotherapy, and various outpatient providers cooperate as needed, e.g., for assisted living.

Lambert M, Kraft V. Manual 8a: Integrated Care for Psychoses including Therapeutic Assertive Community Treatment (TACT) – the Hamburg Model; © UKE 2017, RECOVER-HAMBURG.DE/ PUBLIKATIONEN (accessed on 16.7.2018)

The integrated care model currently consists of the following components:

Inpatient and day-clinic care units in adult and child- and youth psychiatry.
Disease-specific outpatient centers for psychoses, bipolar disorder, major depression and personality disorders.
High fidelity TACT teams, each responsible for about 80-100 patients in a 1:15-1:25 clinicians-patient ratio with 24/365 emergency service. The TACT teams have extensive expertise and are multidisciplinary, including psychiatrists, psychologists, social workers and recovery companions. ≥ 80% are psychiatrists and psychologists.
Within the sector, the model includes 24 registered specialists in psychiatry and psychotherapy, and various outpatient providers cooperate as needed, e.g. for assisted living.

The Hamburg model was examined in three larger evaluations regarding effectiveness and efficiency (ACCESS I to III studies). These studies showed:

Significantly lower treatment interruption rate
Major and lasting improvement of symptoms
Major improvements in work ability and participation in social life
Major improvements in quality of life
Fewer relapses and hospital treatments
Significantly fewer compulsory hospitalisations
Significantly higher outpatient contact frequency
Significantly higher number of patients in individual and/or group psychotherapy
In adolescents and young adults significantly higher chance of simultaneous and permanent remission of symptoms and restoration of functional level
Lower costs

Assertive Community Treatment

Assertive Community Treatment

Care modelsTherapeutic Assertive Community Treatment (TACT)

Care models
Therapeutic Assertive Community Treatment (TACT)