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Assertive Community Treatment 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
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. ACT services are available 24 hours per day, 365 days per year.
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
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.
PRINCIPLES OF ACT
Assertive Community Treatment services adhere to certain essential standards and the following basic principles:
- PRIMARY PROVIDER OF SERVICES: 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.
- 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.
- 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.
- ASSERTIVE APPROACH: ACT team members are pro-active with clients, assisting them to participate in and continue treatment, live independently, and recover from disability.
- 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.
VOCATIONAL EXPECTATIONS: The team encourages all clients to participate in community employment and provides many vocational rehabilitation services directly. EMPHASIS ON
- SUBSTANCE ABUSE SERVICES: The team coordinates and provides substance abuse services.
- 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.
- 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.
- 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.
- ATTENTION TO HEALTH CARE NEEDS: The ACT team provides health education, access, and coordination of health care services.