Assertive community treatment is a specific model of intensive community mental health care and a key component of the national service framework for mental health in England. Over 220 new teams using this model have been implemented since 1999.1 Assertive community treatment originated in the United States, evolving from a pioneering approach to delivery of treatment for people with mental health problems in the community.2 The treatment has been extensively researched. Good evidence exists for its efficacy outside the United Kingdom,3 but results in England have been disappointing.4 5 6 7 Possible reasons for this include differences in adherence to assertive community treatment and differences between the US and the UK in the comparison group of standard community mental health care.8 9 However, even in the UK, clients seen as being “difficult to engage” (those with whom community mental health services have found it difficult to arrange meetings) find assertive community treatment more acceptable than standard community care in terms of satisfaction with services and the amount …