Assertive Community Treatment (ACT)
Overview
Assertive Community Treatment (ACT) is a highly coordinated set of services offered by a multidisciplinary team to meet the complex needs of individuals with severe and persistent mental illness.
A fundamental charge of ACT is to be the first line (and generally sole provider) of all the services that an individual receiving ACT needs. Being the single point of responsibility necessitates a higher frequency and intensity of community-based contacts between the team and individual, and a very low individual-to-staff ratio.
The ACT team is mobile and primarily delivers services in community locations to enable each individual to identify and live in their own residence and to find and maintain work in community.
The ACT Team operates either directly or on-call 24 hours per day, seven days per week. This format is ideally suited for those individuals who demonstrate a clinical necessity for a high level of supportive care, and would not be able to maintain their mental health stability and/or be capable of stopping their illicit substance use otherwise, or at a lesser level of care
Admission Criteria
- Individuals must be 18 years of age or older
- They must have a diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder
- Individuals must have significant functional impairment
- Individuals have one or more of the following problems, which are indicators of continuous high-service needs
- High use of acute psychiatric hospital
- Severe psychiatric symptoms
- Coexisting mental health and substance use disorders of more than 6 months
- High risk or recent history of criminal justice involvement as a result of their mental health disorder symptoms
- Residing in an inpatient setting, but clinically assessed to be able to live in a more independent living situation if intensive services are provided
- Inability to participate consistently in office-based service
Exclusion Criteria
Some individuals are not appropriate to receive services through the ACT Program. If an individual meet any of the following criteria, they would not be eligible for ACT program services:
- The individual’s functional impairment is primarily a result of a substance use disorder, personality disorder, behavioral traits, traumatic brain injury, autism spectrum disorder, developmental disability and/or intellectual disability
- A diagnosis of Intellectual Disability, Personality Disorder or substance use disorder without a primary major mental illness diagnosis
- Individuals with a diagnosis of Traumatic Brain Injuries (TBI) and/or dementia
- The individual’s psychiatric disorder can be effectively treated, or recovery process safely maintained at a less intensive level of care
- Individual or their guardian does not voluntarily consent to admission or treatment, and/or refuses or is unable to participate in treatment
- Individual requires a level of structure and supervision beyond the scope of the program
- The individual’s primary problem is social, custodial, economic (i.e. housing, family, conflict), or one of physical health without a concurrent major psychiatric disorder meeting criterion for this level of care, or admission is being used as an alternative to incarceration
The ACT Team
The ACT team promotes self-determination, respects the person participating in ACT as an individual, and engages peers to promote hope that recovery from mental illness and regaining meaningful roles and relationships in the community are possible. An ACT team provides person-centered services addressing an individuals’ needs and is oriented around individuals’ personal goals.
A multidisciplinary ACT treatment team is comprised of the following:
- Team Leader who oversees all aspects of team operations and provides supervision to ACT staff
- Psychiatric Care Provider who performs psychiatric evaluations and medication monitoring to support individuals in maintaining stability in the community
- Psychiatric Nurses who administer medication, provide basic medical assessments, health education, and health care coordination
- Co-Occurring Disorder Specialist who provides individual and/or group counseling to clients with co-occurring mental health and substance use disorders
- Peer Specialist who have received mental health services and can provide essential first-hand knowledge to the team and support to the individuals recovery goals
- Vocational Specialist who help each individual with seeking, securing, and retaining employment
- Dedicated Office-Based Program Assistant who performs administrative support functions for the team
- Generalist Clinical Staff Members who carry out rehabilitation, therapy and support functions
Services
ACT team delivers all services according to a recovery-based philosophy of care. ACT Services are flexible, offering personalized levels of care that are adjusted to reflect an individual’s needs as they change over time and can include individual, group and family therapy.
- Managing medications
- Finding safe housing
- Getting and maintaining employment
- Scheduling and assisting with keeping medical and dental appointments
- Meeting individuals in their home for psychiatric and nursing visits
- Teaching and assisting with independent living skills
- Opportunities for socialization
- Support for resuming education
- Assistance with obtaining legal and advocacy services, financial support, money management services, medical and dental services transportation, and other supports in the community
