Table 2. Assessments and measures.

Assessments and Measures	Details
Fidelity of the ACT team	Fidelity of the assertive community treatment model was assessed yearly with the Dartmouth Assertive Community Treatment Scale.[18] At initiation of ACCESS, the total score was 4.5 and varied yearly between 4.2 and 4.6 points, indicating that fidelity of the treatment model was good.
Fidelity of ratings	Trained raters independent of the treatment team to avoid bias. All raters received extensive training, particularly for SCID-I interviews, BPRS, CGI-S, and GAF.
Assessment time points	Baseline, week 6, and months 3, 6, 12, 18, 24, 30, 36, 40, and 48
Diagnoses	Diagnoses of the psychotic disorder and comorbid Axis I disorder(s) were assessed with the SCID-I.[16]
Service disengagement	Service disengagement for non-practical reasons was considered to be present if a patient repeatedly refused further treatment despite the need and several attempts at reengagement (phone calls to patient and potentially home visits by the assertive community treatment team).[10]
Service use data	Treatment contacts consisted of face-to-face meetings as well as emails/letters, telephone calls, and contact with institutions or family members. Furthermore, hospital days (inpatient and day-clinic treatment) were noted for each year of treatment. All service use data are presented for patients being actively treated in each year (i.e., excluding service-disengaged patients).
Baseline assessments	■ Sociodemographic, functional, and pretreatment characteristics using the German version of the Early Psychosis File Questionnaire,[19] ■ Employment/occupation using the Modified Vocational Status Index[20] and the Modified Location Code Index.[20] “Employed/occupied” comprised paid or unpaid full- or part-time employment, being an active student in university, a full- or part-time volunteer; “independent living” comprised living alone, with a partner, or with peers. ■ Duration of untreated psychosis with the Duration of Untreated Psychosis Scale.[21–23] ■ Prevalence of previous inpatient treatment, lifetime involuntary admission, and admission within the 2 years before ACCESS were assessed by interviewing patients, relatives, and health service staff previously responsible for the patient. Data were validated by cross checking the hospital database. Involuntary admissions were due to danger to self or others. ■ Medication adherence was assessed using the criteria of Kane et al.[24] Therapists rated their patients as being fully adherent in the last 4 weeks if taking ≥ 80% of their prescribed medications, partially adherent when taking 20%–80%, and nonadherent when taking ≤ 20% of the prescribed medications.
Baseline and follow-up assessments	■ Psychopathology using the BPRS at baseline and every 6 months ■ Severity of illness using the Clinical Global Impressions -Severity of Illness scale (CGI-S)[25] ■ Level of functioning using the Global Assessment of Functioning (GAF) Scale[26]; ■ Quality of life using the 18-item Quality of Life Enjoyment and Satisfaction Questionnaire (QLES-Q-18)[27] ■ Patients’ satisfaction with their care using the Client Satisfaction Questionnaire (CSQ-8)[28] ■ Medication adherence (see previous paragraph above)[24]