Morse 2006.

Methods	Allocation: randomised. Design: single‐centre. Duration: 24 months. Setting: community. Location: St. Louis, Mo, USA.
Participants	Diagnosis: DSM‐IV 48% schizophrenia, 19% schizoaffective disorder, 11% atypical psychotic disorder, 11% bipolar disorder, 9% major depression‐recurrent disorder, 2% other. All had one or more substance use disorders; 46% substance dependence disorder for alcohol and/or drugs; 64% substance abuse disorder for alcohol and/or drugs, 40% an alcohol‐only diagnosis, 18% drug‐only diagnosis, 42% had both drug and alcohol disorders ‐ cocaine most frequently used drug (34%) cannabis (19%).** N = 196.* Age: 18 ‐ 66 years, mean ˜ 40 years. Sex: 119 M, 30 F. Ethnicity: 73% Afro‐American, 25% Caucasian, 2% other. Inclusion criteria: homeless, severe mental illness, DSM‐IV substance use disorder, and not currently enrolled in an intensive case management program.
Interventions	1. Psychosocial intervention: Integrated Assertive Community Treatment. N = 46. 2. Psychosocial intervention: Assertive Community Treatment Team only (ACTO). Referred clients to other community providers for outpatient or individual substance abuse services and to 12‐step groups. N = 54. 3. Standard care: routine care, provided with a list of community agencies (mental health and substance abuse treatment) and staff provided linkage assistance to facilitate access. N = 49.
Outcomes	Unable to use*** Leaving the study early: lost to treatment, lost to evaluation (not reported by group). Substance use: USS (data skewed), number of days using substances (unclear measure). Mental state: BPRS (averaged item scores reported, not totals). Homelessness: number of days in stable housing (data skewed), client satisfaction (not peer‐reviewed scale).
Notes	Not ITT analysis. * Figures are based on the 149 who received treatment. ** Participants paid USD $5 for short and $10 for long interview. *** No usable data, only skewed data reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomised (no further description).
Allocation concealment (selection bias)	Unclear risk	No details.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Clinician‐/participant‐mediated and participants and personnel not blinded. It is not possible to blind a psychosocial intervention.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not clear if raters were independent or blind.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Lost to follow‐up: 24% (47/196) 2 years. Full ITT analysis not reported.
Selective reporting (reporting bias)	High risk	Lost to treatment and evaluation not reported by group. No usable data, only skewed data are reported.
Other bias	Low risk	No evidence other bias occurring.