Assertive Community Treatment

Assertive Community Treatment (ACT) Services

ACT is care for individuals who are experiencing serious mental illness that interferes with their ability to live in the community, attend appointments to meet with professionals in clinics or hospitals, and are unable to manage their mental health symptoms.

ACT is designed to deliver individualized mental health services to address each person’s specific needs in a community setting rather than in an institutional or hospital setting. This treatment is specific to people experiencing serious mental illness.

OhioGuidestone provides ACT services that go beyond counseling alone to improve the daily living experience of those with severe mental illness and in need of medical intervention.

A psychiatrist and a nurse practitioner become part of the mental health plan, by adding and monitoring medication, in addition to one-on-one counseling outside of a hospital or institutional setting.

About ACT

ACT became available in 1972.

Before ACT was available, those with serious mental illness and related health issues were placed in institutions or became homeless or incarcerated. Recovery and quality of life were not a high priority in any of those scenarios.

ACT was founded by Leonard I. Stein, Mary Ann Test, Arnold J. Marx, Deborah J. Allness, William H. Knoedler and other colleagues at Mendota Mental Health Institute in Madison, Wisconsin (a state psychiatric hospital). During the late 1960s, they noted that the gains made by hospital patients were often lost when they returned to their communities. Round-the-clock care helped alleviate patients’ symptoms while in the hospital, but ongoing support and treatment became just as important – if not more so – following a patient’s discharge from the hospital. In 1972, the researchers moved hospital-ward treatment staff into the community to test their assumption and, thus, launched ACT.

Providing treatment outside of the hospital was considered a radical idea at the time. But thorough research and successful care made ACT one of the most important treatment methods for those with severe mental illness. The National Alliance on Mental Illness (NAMI) published an ACT manual and created an ACT training and advocacy center, making ACT one of the most widely researched evidence-based treatments in behavioral healthcare.

The team approach of caring for an individual improves the quality of life for everyone involved.

Study results show that people receiving ACT need fewer intensive, high-cost services and have less involvement with the criminal justice system. They also experience more independent living and higher rates of compliance with a treatment plan.

ACT has also proven to be more effective than standard care in reducing the risk of hospital stays and incarceration, specifically in economically poor communities, and ACT reduces alcohol use and incarceration among those experiencing antisocial personality disorder.

If you or someone you know has been referred to OhioGuidestone’s assertive community treatment program, it has likely been offered for specific reasons.

Who Qualifies for ACT

The following are examples of someone who may qualify for ACT.

• Severe symptoms of mental illness
• Significant thought disorders such as schizophrenia
• Early-stage schizophrenia
• Stigmatized mental illnesses
• Significant history of trauma
• Frequent hospital stays
• Housing insecurity due to mental illness
• Overlapping physical and mental illnesses (for instance, hard-of-hearing individuals with a mental illness)
• Experiences of psychiatric crises
• Mental illness and incarceration
• Being a refugee with a mental illness
• Repeatedly missing clinic or hospital appointments
• Little success in responding to traditional outpatient care

Unlike other community-based programs, OhioGuidestone’s ACT is not a referral program for mental health, housing, or rehabilitation. Rather, we provide highly individualized services directly to our patients. ACT recipients receive multidisciplinary, round-the-clock staffing of a psychiatric unit, but within the comfort of their own home and community. To have the competencies and skills to meet a patient’s multiple treatment, rehabilitation, and support needs, ACT team members are trained in the areas of psychiatry, social work, nursing, substance use, and vocational rehabilitation. The ACT team provides these necessary services 24 hours a day, seven days a week.

The primary goals of ACT

• To lessen or eliminate the debilitating symptoms of mental illness each individual client experiences.
• To minimize or prevent recurrent acute episodes of the illness.
• To meet basic needs of the client and enhance quality of life.
• To improve functioning in adult social and employment roles.
• To enhance an individual’s ability to live independently in his or her own community.
• To lessen the burden on the family providing care.

Key Features of ACT treatment

• Psychopharmacologic treatment, including new atypical antipsychotic and antidepressant medications.
• Individual supportive therapy.
• Mobile crisis intervention.
• Substance use treatment, including group therapy for clients with a dual diagnosis of substance use disorder and mental illness.

Rehabilitation:

• Behaviorally oriented skill teaching (supportive and cognitive-behavioral therapy), including structuring time and handling activities of daily living.
• Supported employment, both paid and volunteer work.
• Support for resuming education.

Support services:

• Education, and skill-teaching to family members.
• Collaboration with families and assistance to patients with children
• Direct support to help clients obtain legal and advocacy services, financial support, supported housing, money-management services, and transportation.