Assertive Community Treatment (ACT/PACT) is an Evidence Based Practice offered by Community Mental Health Providers in Michigan that is available 365 days a year/24 hours a day/7 day s a week. In Michigan the program is most often called ACT for Assertive Community Treatment. When PACT is used the initials stand for Program for Assertive Community Treatment.

Assertive Community Treatment is considered an assertive treatment because when a person is receiving services from an ACT team, the treatment is taken to the person instead of treatment professionals waiting in an office for the person receiving services to come to them. In ACT a primary goal is that 75% to 85% of the contact should be community-based, away from a facility, program or office.

An ACT team’s purpose is to help people along the path to recovery. They often do this by assisting a person in maintaining housing, helping people live on their own (out of a group home), and according to the ACT model, assisting with employment. The ACT model has been developed for over 25 years.

ACT is one of the more intensive programs a community mental health system offers. Assertive Community Treatment is offered when people are displaying significant symptoms of whatever psychiatric diagnosis/mental illness they might have (serious and persistent mental illness or personality disorders). When people have trouble remembering to take medications, spend time struggling with being homeless, have co-occurring sub-abuse problems, end up facing a court or judicial system (especially when mental illness is considered to be a contributing factor), or repeated hospitalizations, a

program like ACT is considered to be beneficial.

The following quote is taken from the ACTA site. ACTA is the Assertive Community Treatment Association http://www.actassociation.org/ and is located in Brighton, Michigan:

“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.”

Assertive Community Treatment is treatment offered by a team of professionals who provide treatment support and rehabilitation activities. ACT Teams are considered to be self-contained. There is a smaller staff to person ratio (national standards state one full-time person for every ten people receiving services, and the psychiatrist is not included in that count).

An ACT Team may include a:

Team leader

Psychiatrist

Registered nurse

Social worker

Rehabilitation counselor

Supported employment specialist

Peer support specialist

Case manager

Program assistant

… and the ACT team may include many others. Since an ACT Team is considered to be self-contained, there are a wide variety of people who are able to “specialize” in what someone may want and need. One example of this is a supported employment specialist.

In a rural area the team may not be as large or as comprehensive as in an urban area. According to national standards, the peer support specialist is not considered an option of a position in a rural area.

The entire ACT team is considered to be a unit that offers not just comprehensive mental health and substance abuse care, but also coordinates/integrates whole health care. That means that the ACT team is responsible for seeing to an individual’s physical as well as mental health.

ACT teams make multiple contacts with someone receiving services each week, and should be able to quickly increase services, if the person receiving services requires more assistance.

The case manager is the staff who has the responsibility of maintaining the relationship with the individual whether they are in the hospital, the community or involved in the community. Much of the service that is provided by the ACT team is governed by an Individualized Plan of Service (IPOS) that is taken from the person-centered planning meeting that any individual receiving public or community mental health services in Michigan has at least once a year.

Medication Management is one cornerstone of this program and is considered to be a joint responsibility of both the person receiving services and the ACT Team staff.

There are national admission and discharge criteria for ACT services. The reason for the discharge criteria is because so many people with a severe or severe and persistent mental illness have been inappropriately discharged.

There are several principles that ACT is well known for. They are:

Long-term - People in ACT are supported for a longer period of time than those in other community-based services.

Community-based - The program is designed so that people do not have to regularly visit a facility or office.

Substance abuse services - Substance abuse is treated as part of the integrated health vision.

Person-centered- Each person’s Individual Plan of Service is based on a person-centered plan and each person has a say in what happens to them.

Vocational expectations- People are able to recover, and should be able to participate in Supported Employment.

Family involvement and education - Whenever possible natural support systems are used to help the person receiving ACT services gain a better recovery.

Whole health - ACT services have a whole health perspective through the team approach of coordination of physical care and mental health support.

For more information about Assertive Community Treatment:

NAMI ACT Technical Assistance Center

ACTA

Wikipedia