REACT‐UK 2002.

Methods	Allocation: randomised. Design: multicentre (2 centres, information for single centre not available). Duration: 18 months. During this period, participants remained allocated in their trial arm. Follow‐up: 36 months and 10 years after randomisation (i.e. 18 months and 8.5 years after the active intervention was provided). During the follow‐up period, participants could remain in the originally allocated intervention (ICM) or be transferred to the control one. Country: London, UK.
Participants	Diagnosis*: SMI (schizophrenia, schizoaffective disorder, other chronic psychosis, bipolar affective disorder). N = 251. Setting: community services in 2 inner London boroughs (Camden and Islington). Age: mean 39 years (SD 11). Sex: 58% M. Ethnicity: African‐Caribbean 36%. History: i. living independently or in low‐supported accomodation, ii. under the care of CMHT ≧ 12 months and having difficulty engaging with standard community care, iii. recent high use of inpatient care (i.e. ≧ 100 consecutive inpatient days or ≧ 5 admissions during previous 2 years, or ≧ 50 consecutive inpatient days or ≧ 3 admissions previous 1 year), iv. substance misuse or personality disorder eligible if these were secondary diagnosis, v. no organic brain damage.
Interventions	1. ICM: Assertive Community Treatment (as described by McGrew 1995). Caseload: 1:12. N = 127. 2. Non‐ICM: services offered by CMHT (according to Care Programme Approach). Caseload: 1:35. N = 124.
Outcomes	Service use: average number of days in hospital per month, not remaining in contact with psychiatric services (defined as no face‐to‐face contacts between staff and client in previous 3 months), average admission, admitted to hospital. Death: all causes and suicide. Global state: leaving the study early, Health of the Nation Outcome Scale (HoNOS), Rating of Medication Influence scale (ROMI). Social functioning: arrested, imprisoned, number homeless, living independently, living in supported accomodation, Life Skill Profile (LSP), substance abuse: assessed through various scales (Alcohol Use Scale ‐ AUS, Drug Use Scale ‐ DUS, Substance Abuse Treatment Scale ‐ SATS), but reported as binary outcome. Mental state: Brief Psychiatric Rating Scale (BPRS‐24 item). Behaviour: self harm, injury to others. Quality of life: Manchester Short Assessment of Quality of Life (MANSA). Participant satisfaction: Client Satisfaction Questionnaire modified version (CSQ‐modified), Camberwell Assessment Need abbreviated form (CAN). Unable to use ‐ Use of Mental Health Act (not listed as review outcome of interest). Quality of engagement: adapted form of Homeless Engagement Acceptance Scale (HEAS) (not listed as review outcome of interest).
Notes	*53% schizophrenia; 13% schizoaffective; 4% bipolar; 26% illicit drug misuse; 25% alcohol misuse.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomised: permuted block randomisation with a block size of 8 ensuring parity between CMHT in proportions randomised to ICM.
Allocation concealment (selection bias)	Low risk	The interviewer contacted an administrator at the trial centre who opened the appropriate numbered envelope communicating the outcome of randomisation. Participants and referrers were informed of the treatment assignment by letter.
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Primary outcome: clinician/participant mediated ‐ rating ‐ Unclear. Secondary outcomes: interviewer rated ‐ rating ‐ No. Interviewers were independent of clinical care, but not blind.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Blinding not reported.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Source of service use data not reported. Self harm, violence, contact with legal services, quality of life, compliance with medication, and mental state were obtained from interviews with clients. Other scales were completed by care co‐ordinators. All additional data were collected from case notes. Assessors not blinded.
Incomplete outcome data (attrition bias) All outcomes	Low risk	YES ‐ Primary outcomes: average number of days in hospital per month. No missing data (except death, balanced in numbers across groups). YES ‐ Secondary outcomes: number and reasons for missing data are reported. Analysis carried out on an ITT basis.
Selective reporting (reporting bias)	Low risk	All of the listed outcomes of interest are completely reported.
Other bias	Low risk	Publicly funded (Camden and Islington Health Authority; King's Fund; Department of Health). Competing interesting declared: none. No further details. No evidence of the presence of other bias.