Distribution and Correlates of Assertive Community Treatment (ACT) and ACT-Like Programs: Results From the 2015 N-MHSS

Abstract

The study examined the availability and characteristics of assertive community treatment (ACT) programs across mental health treatment facilities in the United States.Methods: Prevalence and correlates of facilities that reported offering ACT, broadly defined as intensive community services for serious mental illness provided by multidisciplinary teams in the clients' natural settings and including both ACT and "ACT-like" programs, were examined by using data from the National Mental Health Services Survey. Availability of services essential to the ACT model in these facilities was also examined.Results: Of the 12,826 surveyed facilities, 13.4% reported offering ACT, with significant variability among states. Of the facilities with ACT, 19.2% reported offering all core ACT services. Few facilities offered peer support, employment, and housing services. Compared with programs at facilities that did not offer all core ACT services, facilities with ACT programs that offered these services had higher odds of being publicly owned (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.64-2.74) and of receiving federal (OR=3.60, CI=2.17-5.98) or grant funding (OR=1.87, CI=1.45-2.41). Facilities with ACT that offered all core services also had higher odds of offering other services important to individuals with serious mental disorders.Conclusions: Substantial differences existed in availability of ACT and ACT-like programs among states, with evidence of a large unmet need overall, even when a very broad and inclusive definition of ACT was used. Few ACT programs offered all core services. Legislative, administrative, and funding differences may explain some of the variability.

Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

“…Deinstitutionalization of the 1950s-1970 s was followed by several other major social changes that stimulated the development of novel community-based public mental health services. While the effectiveness, and cost-effectiveness of these specialized services has been demonstrated in randomized trials [62,36,63,25], evaluation of the acessabiity and effectiveness of such programs in the context of large regional and national service systems is a far more challenging task, and remains to be undertaken.…”

Social determinants of mental health care systems: intensive community based Care in the Veterans Health Administration

“…Local studies based on Medicaid data do show that community programs continued to provide ACT and ACT-like services to the most seriously mentally ill and functionally impaired adults [64], though one recent survey suggested that less than 20% of non-VA community mental health facilities offer ACT [65] and even fewer offer other community services such as peer support, employment, and housing services [66]. While most research has focused on either people who use less intensive services (i.e.…”

Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

“…Local studies based on Medicaid data show that community programs continued to provide ACT and ACT-like services to the most seriously mentally ill and functionally impaired adults [56], though a recent survey suggested that less than 20% of non-VA community mental health facilities offer ACT [57] and even fewer offer other community services such as peer support, employment, and housing services [58]. While most research has focused on either people who use less intensive services (i.e.…”