Forensic Assertive Community Treatment (ACT)

The ACT program is designed to provide comprehensive, person-centered mental health services through a mobile, multidisciplinary team. This approach focuses on supporting individuals with severe psychiatric conditions who have not been effectively helped by traditional mental health services. ACT is rooted in a recovery-oriented model, offering flexible, individualized services with a focus on recovery, community integration, and preventing relapses or hospitalizations. The core principles of ACT include providing treatment in the community, small caseloads (no more than 10 individuals per staff member), shared team responsibility, and 24/7 crisis intervention. Services are adjusted regularly to meet the evolving needs of individuals, and care is provided for as long as necessary. Key outcomes expected from ACT include improved engagement in treatment, stable housing, reduced psychiatric symptoms, better management of medication, decreased substance use, and enhanced physical health. The program also aims to reduce hospital admissions, emergency room visits, and involvement with the criminal justice system while helping individuals attain vocational and educational goals. ACT teams offer a range of services, including case management, psychiatric care, substance use counseling, crisis intervention, and psychosocial rehabilitation. The services are delivered with a culturally responsive, trauma-informed approach, ensuring care is tailored to the individual's preferences, cultural background, and personal goals. ACT teams are multidisciplinary, often including a psychiatrist, nurse, social worker, substance use specialist, vocational specialist, and peer support specialist. The team works closely with individuals to create a person-centered service plan that addresses their mental health, physical health, and social needs. The document also describes specific guidelines for young adult ACT teams, which cater to individuals aged 18 to 25. Young adults in this program often require additional support in developing life skills necessary for independent living, such as financial literacy, time management, and decision-making. These teams also focus on building a strong vocational or educational plan and providing support to strengthen social and family networks. Eligibility for ACT is generally restricted to individuals with SMI who have high service needs, including frequent psychiatric hospitalizations, use of emergency services, or homelessness. The ACT team is responsible for ensuring individuals are transitioned to less intensive services when appropriate. This includes a formal discharge process when individuals demonstrate the ability to manage independently or move out of the team’s geographic area. In terms of staffing, ACT teams must meet specific ratios, with no more than 10 individuals assigned per team member, excluding psychiatrists and program assistants. Teams must include professionals with relevant experience, and all staff are required to undergo specialized training to ensure they are equipped to provide integrated, evidence-based care. The guidelines also emphasize the importance of coordination between ACT teams and other systems, including psychiatric inpatient facilities, housing agencies, and the criminal justice system, to ensure a comprehensive and seamless approach to care. The document sets standards for program certification, quality management, utilization review, and incident reporting, ensuring that ACT teams maintain high standards of care and accountability.