Assertive Community Treatment

Assertive Community Treatment (ACT) is a client-centered, recovery-oriented mental health service intended to facilitate psychosocial rehabilitation for persons who have the most serious mental illnesses and have not benefited from traditional programs.

People who have an ACT team supporting them have often been in the hospital many times or have been homeless. Some ACT teams focus on people with special needs, like people who have been involved in the criminal justice system, or who have a dual diagnosis (both mental illness and developmental disability) or a concurrent diagnosis (both mental illness and substance use disorder).

ACT services are individually tailored to address the preferences and goals of each client. The ACT team is mobile and delivers services in community locations that are comfortable and convenient for clients.

ACT services are delivered by a multidisciplinary team who provide treatment, rehabilitation, and support services. The team is directed by a coordinator and a psychiatrist and includes a sufficient number of staff to work in shifts to cover 24 hours per day, seven days a week. Each team in Ontario includes

• a team coordinator
• registered nurses
• a social worker
• an occupational therapist
• a substance abuse specialist
• a vocational specialist
• a peer specialist
• a psychiatrist
• a program/administrative assistant

Among the services ACT teams provide:

• case management
• crisis assessment and intervention
• symptom assessment, management and individual supportive therapy
• medication prescription, administration, monitoring and documentation
• provision of substance abuse services
• work-related services
• activities of daily living
• social, interpersonal relationship and leisure-time skill training
• education, support and consultation to clients' families and other major supports

Both assertive community treatment teams and intensive case management services will work with the family members of their clients. They can learn more about a person's illness, strengths and goals from family members. They may also be able to teach the family about ways to support and help their family member with a mental illness. In some cases, they may be able to offer support to the family members themselves.

Related Resources

Policy Recommendations

Intensive services are a key part of a continuum of mental health services. CMHA, Ontario has supported new investments and evaluation of assertive community treatment and intensive case management services.

• People with Mental Illness and Addiction Will Benefit from Investment into Services (July 14, 2005)
  This media release from CMHA, Ontario, the Centre for Addiction and Mental Health and the Ontario Federation of Community Mental Health and Addiction Programs applauds new funds to support people with mental illness and addiction in their communities.

ACT in Ontario

Assertive Community Treatment teams in Ontario, Mental Health Service Information Ontario

Ontario Program Standards for ACT Teams (PDF), Ministry of Health and Long-Term Care

Ontario ACT Association

Community Mental Health Evaluation Initiative

• A Randomized Controlled Trial of Assertive Community Treatment in a Canadian Inner City Setting
• Variations on Assertive Community Treatment

Champlain District Mental Health Implementation Task Force, Foundations for Reform, Sec. 96, Assertive Community Treatment (PDF)

Measuring Client Satisfaction with Assertive Community Treatment

International Comparative ACT Study Process and Data: How ACT Teams Compare in Toronto, Birmingham, Nashville and Auckland (February 2009)

ACT in Other Jurisdictions

Assertive Community Treatment Association (USA)

Assertive Community Treatment, NAMI

A goal of the National Alliance on Mental Illness is to promote the role of ACT teams and to educate people on the effectiveness of the model.

Links

Assertive Community Treatment teams in Ontario, Mental Health Service Information Ontario

Ontario Program Standards for ACT Teams (PDF), Ministry of Health and Long-Term Care

More Intensive and Specialized Support, Challenges and Choices: Finding Mental Health Services in Ontario, Centre for Addiction and Mental Health

Includes information on ACT teams, intensive case management, specialized outpatient services in psychiatric facilities, forensic services and home care.

Outcomes and Effectiveness: The Success of Community Mental Health and Addiction Programs (PDF), Ontario Federation of Community Mental Health and Addiction Programs, 2003

This advocacy paper makes the case for the important role that community mental health and addiction programs make in the lives of their clients.

Making A Difference: Ontario's Community Mental Health Evaluation Initiative, Centre for Addiction and Mental Health, CMHA Ontario, Ontario Mental Health Foundation, Ontario Ministry of Health and Long-Term Care

This 2004 report is a summary of the different research projects that were funded by the Ontario government to better understand how community mental health services are working. Both ACT and intensive case management services were shown to help people use less institutional care and improve their quality of life.

Psychosocial Rehabilitation Canada

This is the national organization of psychosocial rehabilitation practitioners. Psychosocial rehabilitation is a model of providing services to support people with mental illness in their recovery. Some mental health professionals have specialized training in psychosocial rehabilitation principles.

Advanced Search | Tips