From the hospital to the community: A shift in the primary locus of care

Abstract

A community‐based mental health team assertively providing a variety of support services to both the patient and the community can effectively treat the patient, substantially reduce use of the hospital, and virtually eliminate the revolving‐door syndrome.

Daily Time Use as a Measure of Community Adjustment for Persons Served By Assertive Community Treatment Teams

“…These studies have typically focused on quality of life and employment outcomes. Early reports by the originators of the ACT model (Stein & Test, 1979) stated that ACT clients experienced a better quality of life then those who were hospitalized, but these differences were not found when ACT was compared to other community-based case management programs (McGrew, Bond, Dietzen, McKasson, & Miller, 1995). Quality of life research in community mental health has been associated with several limitations including the difficulties associated with improving the harsh community lives of persons with severe mental illness (Davidson, Hoge, Merrill, Rakfeldt, & Griffith, 1995), the methodological shortcomings of quality of life research and disagreement about the variables that influence quality of life (DeSouza, 2000).…”

Reflections On… Occupational Therapy and Assertive Community Treatment

“…The client-staff ratio is low in order to provide all clients with the intensity of services they require and at the time they are required. ACT works with both the individual and the environment; community living skills are developed in vivo and ACT emphasizes the establishment of supportive community environments (Stein & Test, 1979, Stein & Test, 1980McGrew, Bond, Dietzen & Salyers, 1994;McGrew & Bond, 1995).…”

Challenges Faced by Service Providers in the Delivery of Assertive Community Treatment

“…Assertive Community Treatment (ACT) is a model of service delivery that provides continuous services to promote the community adjustment of persons with severe mental illness and high service usage (Stein & Santos, 1998). Originating in the 1970s, the ACT model was developed as a community-oriented alternative within a service system that largely conceptualized community care as hospital-based, outpatient treatment (Stein & Test, 1979, 1980 Considerable research evidence has supported the model's effectiveness in increasing community tenure and residential stability, and improving symptoms and a subjective sense of quality of life (Bond, Drake, Mueser, & Latimer, 2001). ACT has been widely replicated and disseminated through targeted initiatives to standardize the model's implementation and formal associations (see for example, NAMI, 1996).…”