What are the key elements of Assertive Community Treatment that our organization should be sure to include when implementing these programs?

Assertive community treatment (ACT) is an evidence-based psychiatric practice that provides a team-based, comprehensive approach to care for individuals with severe mental illness (SMI). ACT uses a multidisciplinary team, which typically includes a psychiatrist, a nurse, and at least two case managers. Increasingly, these teams are also incorporating certified peer specialists to assist with engagement and the recovery process. ACT is characterized by (1) low client to staff ratios (no more than 10 clients per staff member); (2) providing services in the community; (3) shared caseloads among team members; (4) 24-hour availability of the team, (5) direct provision of all services by the team rather than referral; and (6) time-unlimited services.

You can assess whether your program is adhering to these standards through the use of the ACT Fidelity Scale. This scale contains 28 ACT Team-specific items. Each item on the scale is rated on a 5-point scale ranging from 1 (“Not implemented”) to 5 (“Fully implemented”). The scale ratings are based on current activities, not planned or intended behavior.


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