Assertive community treatment

So the, we had this influx of folks with mental health issues in our communities, and a complete lack of services that were designed to help them.

And in response to that, most if not all states that I've come across have accepted some form of, uh, assertive community treatment teams, these ACT teams.

And the way you have it set up is unique to your state.

Uh, it's different than the way that we have it set up up here, but the mission is the same.

We attempted to interview mental hygiene legal services attorneys who are the primary, overwhelmingly primary provider of legal counsel for individuals facing an AOT order.

and providers in both Health Home Plus and ACT Team context who are actually working with folks on AOT orders, state-level advocates involved typically in state-level policy, And family members.

So, you know, so a lot of different kind of groups that end up reflected then in the larger qualitative data.

But in terms of the individual's perspective on how they're being impacted, that can, of course, only come from individuals under the orders.

The voluntary pathways to access are often very difficult.

And as we in part documented through a survey we did of all 63 counties in New York, wait lists can be very long, as long as two years in a lot of larger urban areas.

And there are also counties that are so small that they don't have ACT teams, just as a caveat.

But so there's that.

What about intensive support for chronic long-term cases?

The traditional medical model uses ACT-assertive community treatment.

It is highly effective at keeping people out of inpatient wards.

It functions like a hospital without walls.

Spot on.

And this realization paved the way for assertive community treatment or ACT teams.

ACT was a massive leap forward, wasn't it?

It was.

You must, and you do that by rigorously applying the triad we've explored.

Opportunity, tearing down the barriers to housing first and competitive employment.

Support, providing the vital bridge through IPS and assertive community treatment teams.

And skills, leveraging mobile technology, EMA, and community-based learning to teach the patient how to navigate their actual world, not a clinical simulation.