Essock‐Connecticut2 2006.

Methods	Allocation: randomised. Design: multicentre, 2 urban sites (data for single centre not available). Duration: 36 months. Country: Bridgeport, Connecticut, USA.
Participants	Diagnosis*: schizophrenia, schizoaffective disorder, depression with psychotic features, bipolar disorder according to DSM‐III‐R. N** = 198 (randomised to site A: N = 100, to site B: N = 98). Setting: 2 state‐operated outpatient CMHCs. Age: mean 36.5 years (SD 7.8 years). Sex: 72% M (143M, 55F). Ethnicity: African‐American 55%; Hispanic 14%. History: i. active substance use disorder (abuse or dependence on alcohol or other drugs previous 6 months), ii. high service use previous 6 months (≧ 2 between: psychiatric hospitalisation, stays in a psychiatric crisis or respite programme, emergency department visit, or incarceration), iii. homeless or unstably housed, iv. poor independent living skills, v. no pending legal charge, vi. no medical condition or mental retardation, vii. written informed consent given.
Interventions	1. ICM***: Assertive Case Management. Caseload: 1:10‐15. N = 99. 2. Non‐ICM***: Clinical Case Management provided by clinicians. Caseload: 1:20‐30. N = 99.
Outcomes	Service use: average number of days in hospital per month. Unable to use ‐ Global state: leaving the study early, GAS (N for single intervention group not reported). Social functioning: days in stable accomodation (N for single intervention group not reported), imprisoned (days in jail reported with days in hospital). Social functioning: SATS, AUS, DUS (scales rated by clinicians), days of alcohol/drug use (N for single intervention group not reported). Mental state: BPRS‐24 item (N for single intervention group not reported). Client satisfaction: General Life Satisfaction (N for single intervention group not reported). Costs: not reported.
Notes	*76% schizophrenia or schizoaffective disorder; 17% mood disorder; 74% alcohol disorder; 81% substance use disorder. **Original randomised sample N = 205. 7 participants left for administrative reason. Authors did not report to which group they were assigned. ***Both interventions addressed substance use disorders.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomised using separate computer‐generated randomisation stream for each site.
Allocation concealment (selection bias)	Unclear risk	No details
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No details
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	No details
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No details
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Insufficient reporting of missing data (number and reasons for missing data reported for the total sample, not for each intervention group). 7 randomised participants were lost due to administrative reason, but their intervention allocation was not reported.
Selective reporting (reporting bias)	High risk	Listed outcomes of interest are fully reported for each site, but authors did not provide sample size.
Other bias	Low risk	Publicly funded. No further details. No evidence of the presence of other bias.