Adult Assertive Community Treatment (ACT) is a service delivery model for supporting persons with serious mental illness, multiple diagnoses and complex treatment needs. A goal of ACT is to promote recovery by providing access to treatment in the community that is available seven days a week, 24 hours a day and by providing rehabilitation. People with mental illness often experience multiple barriers that make it difficult to live successfully on their own in the community. Co-occurring substance abuse or dependence, homelessness and unemployment may create challenges that add up to lower quality of life outcomes. ACT is a team-based approach that addresses activities related to:
- Supporting use of community living, personal, and social skills;
- Increasing symptom stability and use of appropriate medication;
- Addressing substance abuse issues;
- Promoting physical health and wellness;
- Assisting with financial issues related to entitlements, housing, work and social opportunities; and
- Promoting the highest possible level of independent and autonomous functioning in the person’s community of choice.
Instead of visiting an office or hospital, ACT teams provide support to people in their homes, neighborhoods, and other locations where stressors are experienced or additional skills and strategies are needed. The person receives services whenever it is needed rather than during structured, monthly, scheduled appointments. There are no preset time periods for ACT services. However, over time, team members may see people less frequently as they experience success living in the community.
Team-based Action Planning
ACT Teams work with people to provide treatment and manage mental illnesses while developing the skills each person needs for life in his or her chosen community. Each ACT has a team leader who provides direct services at least 50% of the time. Teams typically include:
- Psychiatrist,
- Mental health professionals,
- One or more nurses,
- Substance abuse specialists,
- Supported employment specialists,
- Certified peer specialists, and
- Other mental health professionals, practitioners, or rehabilitation workers.
ACT teams work together with the person to help ensure he or she will be successful in maintaining relationships, working, and managing mental and physical health and everyday living activities. ACT helps decrease the use of inpatient psychiatric care and to prevent homelessness. Instead of independent case loads, ACT team members work together and share responsibilities for the people receiving services. Caseloads are small so that careful attention can be given to a person who is participating in ACT.
Achieving Goals and Improving Quality of Life
The ACT team works together to assist a person in identifying important life goals. Progress is monitored daily by the person and his or her team. When the goals are not being met, the team assesses whether needs have shifted or additional supports should be added. The types of goals that are identified may address a number of different issues including:
- Housing related topics,
- Everyday activities,
- Family interaction and life,
- Employment and Financial Management,
- Medication an Benefits, and
- Co-occurring and integrated treatment.
10 Principles of ACT
- Services are targeted to a specified group of individuals with severe mental illness.
- Treatment, support and rehabilitation services are provided directly by ACT team
- Team members share responsibility for the individuals served by the team
- The staff-to-consumer ratio is small (Approx. 1 to 10)
- The range of treatment and services is comprehensive and flexible
- Interventions are carried out at the locations where problems occur and support is needed rather than in hospital or clinic settings
- There is no arbitrary time limit on receiving services
- Treatment and support services are individualized
- Services are available on a 24-hour basis
- The team is assertive in engaging individuals in treatment and monitoring of their progress
Source: Assertive Community Treatment (ACT) Evidence-Based Practices (EBP) KIT