In the field of psychiatric rehabilitation, one of the best established evidence-based practices is “ACT”, or Assertive Community Treatment. ACT is a comprehensive community outreach care modality for persons with psychiatric disabilities that do not or cannot participate in group programs at a central site. PACT teams consist of a full transdisciplinary group of mental health professionals reaching out together: psychiatrists, therapists, case workers, specialists in co-occurring disorders, supported employment, supported education, and peer counselors (Schmidt, Pinninti, Garfinkle, & Solomon, 2013). ACT is like a hospital without walls.
The concept originated in Wisconsin in the 1960s (Stein & Test, 1980). It is based on several service principles, e.g.:
- Comprehensive, intensive, individualized care
- Assertive, flexible, open-ended, consumer-based care
- 24/7 availability
In New Jersey, the practice is called PACT, for Program of Assertive Community Treatment. The New Jersey Division of Mental Health and Addictions Services contracts with various community agencies around the state to provide PACT services. (For a list of all New Jersey mental health service providers, including PACT, click here.)
Assertive Community Treatment is effective both in its clinical outcomes and its economic value (SAMHSA, 2008). It is also very hard work. ACT work is indeed almost a calling, and loved ones and their families can greatly benefit from the special care it delivers.
Catholic Charities Trenton, which fields 4 PACT Teams, has produced an insightful 18 minute video that soberly portrays the intense work performed every day by its PACT teams. The video can help families in the maelstrom understand the dimensions and difficulties of this important care modality.
Schmidt, L. T., Pinninti, N. R., Garfinkle, B., & Solomon, P. (2013). Assertive community treatment teams. In K. Yeager, D. Cutler, D. Svendsen, & G. M. Sills (Eds.), Modern community mental health: An interdisciplinary approach (pp. 293-301). New York: Oxford University Press. Retreived on January 7, 2016 from https://books.google.com/books?hl=en&lr=&id=mRtpAgAAQBAJ&oi=fnd&pg=PA293&dq=garfinkle+assertive+community+treatment&ots=EgyyZMQkGO&sig=2MINsbnyiwfBUjywGANEFlGieo0#v=onepage&q=garfinkle%20assertive%20community%20treatment&f=false.
Stein, L. I., & Test, M. A. (1980). Alternative to mental hospital treatment. Archives of General Psychiatry, 37, 392-397.
Substance Abuse and Mental Health Services Administration. (2008). Assertive community treatment: Evidence-based practices (EBP) kit. (DHHS Pub. No. SMA-08-4344). Rockville, MD: Center for Mental Health Services Retrieved from http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBP-KIT/SMA08-4345.