The ACT Model

A Team Approach

A team treatment approach for persons with serious and persistent mental illness

Assertive Community Treatment (ACT) is a team treatment approach designed to provide comprehensive, community-based psychiatric treatment, rehabilitation, and support to persons with serious and persistent mental illness such as schizophrenia.

The ACT model of care evolved out of the work of Arnold Marx, M.D.Leonard Stein, and Mary Ann Test, Ph.D., in the late 1960s. ACT has been widely implemented in the United States, Canada, and England. The Department of Veterans Affairs has also implemented ACT across the United States.

ACT services are available 24 hours per day, 365 days per year.

A team of professionals whose backgrounds and training include social work, rehabilitation, counseling, nursing and psychiatry provide Assertive Community Treatment services. Among the services ACT teams provide are: case management, initial and ongoing assessments; psychiatric services; employment and housing assistance; family support and education; substance abuse services; and other services and supports critical to an individual”s ability to live successfully in the community.

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An evidence-based practice

An evidence based practice, ACT has been extensively researched and evaluated and has proven clinical and cost effectiveness. The Schizophrenia Patient Outcomes Research Team (PORT) has identified ACT as an effective and underutilized treatment modality for persons with serious mental illness.

Persons Served by ACT

Persons who have avoided or not responded well to traditional outpatient mental health care

Clients served by ACT are individuals with serious and persistent mental illness or personality disorders, with severe functional impairments, who have avoided or not responded well to traditional outpatient mental health care and psychiatric rehabilitation services.

Persons served by ACT often have co-existing problems such as homelessness, substance abuse problems, or involvement with the judicial system.

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Principles of ACT

Assertive Community Treatment services adhere to certain essential standards and the following basic principles:

There are minimal referrals to other mental health programs or providers.

Primary Provider of Service

The multidisciplinary make-up of each team (psychiatrist, nurses, social workers, rehabilitation, etc.) and the small client to staff ratio, helps the team provide most services with minimal referrals to other mental health programs or providers. The ACT team members share offices and their roles are interchangeable when providing services to ensure that services are not disrupted due to staff absence or turnover

A community setting

Services Are Provided Out of Office

Services are provided within community settings, such as a person’s own home and neighborhood, local restaurants, parks and nearby stores.

A community setting

Highly Individualized Services

Treatment plans, developed with the client, are based on individual strengths and needs, hopes and desires. The plans are modified as needed through an ongoing assessment and goal setting process.

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Pro-active assistance

Assertive Approach

ACT team members are pro-active with clients, assisting them to participate in and continue treatment, live independently, and recover from disability.

The process of recovery often takes many years.

Long-Term Services

ACT services are intended to be long-term due to the severe impairments often associated with serious and persistent mental illness. The process of recovery often takes many years.

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Community employment is expected and facilitated.

Emphasis on Vocational Expectations

The team encourages all clients to participate in community employment and provides many vocational rehabilitation services directly.

Coordinated substance abuse services

Substance Abuse Services

The team coordinates and provides substance abuse services.

Clients and their families learn about mental illness.

Psychoeducational Services

Staff work with clients and their family members to become collaborative partners in the treatment process. Clients are taught about mental illness and the skills needed to better manage their illnesses and their lives.

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Natural support systems are included.

Family Support and Education

With the active involvement of the client, ACT staff work to include the client”s natural support systems (family, significant others) in treatment, educating them and including them as part of the ACT services. It is often necessary to help improve family relationships in order to reduce conflicts and increase client autonomy.

Encourage participation in community activities.

Community Integration

ACT staff help clients become less socially isolated and more integrated into the community by encouraging participation in community activities and membership in organizations of their choice.

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Encourage participation in community activities.

Attention to Health Care Needs

The ACT team provides health education, access, and coordination of health care services.