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Assertive Community Treatment FACT SHEET

What is assertive community treatment?

Assertive community treatment (ACT) is a model of psychiatric care that can be very effective in the treatment of severe mental illness. ACT is aimed at providing comprehensive multidisciplinary care to the people who need it the most. Similar to the treatment team model of an inpatient psychiatric unit, which includes nurses, psychiatrists, social workers, case managers, occupational therapists and other trained professionals, ACT is based around the premise that people receive better care when their mental health providers are working together. ACT aims to provide the same level of thorough, round-the-clock, psychiatric care for people once they leave the inpatient unit.

What are the primary goals of ACT?

ACT strives to decrease the debilitating symptoms of severe mental illness that affect each individual in different ways. By developing individual treatment plans with a multidisciplinary team, the primary goals of preventing acute relapse and psychiatric hospitalization are emphasized so that an individual has the opportunity to live more independently in an outpatient setting. Increased ability to function independentlythrough improved social relationships, finding and maintaining employment and family supportremains a primary goal of ACT. An individual with ACT can also expect to have support with medication adherence, which is a cornerstone of treatment for severe mental illness.

What are the key features of ACT?

Approximately 50 percent of individuals hospitalized for severe mental illness will have difficulty connecting with their outpatient treatment team. One of the most powerful things that ACT has to offer is the treatment teams expectation to seek out their patients for appointments. Rather than have a patient meet at a hospital or another office, ACT visits usually occur at the patients place of residence. ACT is also more fluid and accessible to patients with the opportunity to change appointment days and times in order to meet an individuals immediate needs. While one of the main goals of ACT is to decrease the need for emergency psychiatric servicesincluding both ER visits and inpatient hospitalizationsACT team members are also well-connected with local hospitals and have the ability to work with hospital and emergency room staff. ACT teams are regularly in touch with a patients hospital team members and frequently visit inpatient psychiatric hospitals to aid in treatment plan and discharge arrangements. Following discharge, ACT team case managers assist in helping patients attend any follow up appointments or meetings they might have in the community setting.

NAMI The National Alliance on Mental Illness 1 (800) 950-NAMI 3803 N. Fairfax Drive, Suite 100, Arlington, Va. 22203 1

Assertive Community Treatment FACT SHEET

ACT has a unique focus on rehabilitation and recovery that serves as a guiding philosophy for treatment. Patients will usually have individual therapy as part of their involvement with ACT, and a solution-focused, cognitive behavioral therapy mode of treatment is frequently used. ACT will involve aiding the individual in resuming educational pursuits or finding regular employment to help the patient become more involved in their community, increase daily structure and provide self-esteem. ACT can also help patients with other necessary supports such as coordinating legal and financial services. ACT clinicians will also invest significant resources in supporting and educating the family members of their patients. This can involve family meetings, individual family support and connecting family members with other resources in the community.

Who benefits from the ACT model?

ACT is indicated for individuals of all ages, gender and ethnicity with severe and persistent mental illness. People who receive ACT services are usually living with schizophrenia and other psychotic disorders. Most people with ACT experience significant disability from their mental illnesses and have not been adequately served by traditional outpatient models.

How does ACT compare with traditional treatment?

Multiple studies have shown that ACT is an effective treatment model for people with severe mental illness. In general, people receiving ACT services spend significantly less time in hospitals, are more likely to remain employed, experience more positive social relationships, have greater satisfaction with life and experience less debilitating symptoms from their mental illness. A prominent study suggests that patients receiving ACT were hospitalized less than 20 percent as often when compared with individuals who did not receive these services. Furthermore, people receiving ACT were hospitalized for shorter periods of time before returning to their homes. In previous decades, ACT was not available in all areas, even for people with the most complicated mental illnesses. As multiple studies have suggested that ACT is less expensive for taxpayers than institutional care, more communities and government agencies are developing the resources to bring ACT to the people that need it most. Family members and loved ones should feel empowered to discuss the possibilities of ACT services with their loved ones treatment team. If it is clinically indicated, ACT services can be very helpful in the treatment of chronic mental illness. Reviewed by Ken Duckworth, M.D., and Jacob L. Freedman, M.D., February 2013

NAMI The National Alliance on Mental Illness 1 (800) 950-NAMI 3803 N. Fairfax Drive, Suite 100, Arlington, Va. 22203 2