Harvard Mental Health Letter

Assertive community treatment

This individualized, comprehensive care benefits patients with severe mental illness.

State budget cuts are slashing mental health budgets and, in doing so, further reducing access to one of the most effective programs for patients with chronic mental illness — assertive community treatment (ACT). Developed in the 1970s by mental health professionals in Wisconsin, ACT was designed to help patients with serious and persistent mental illnesses function better in the community. ACT is now recognized as an effective treatment option for individuals with bipolar disorder, schizophrenia, or other severe psychiatric conditions, especially those who have been repeatedly hospitalized.

ACT programs rely on multidisciplinary teams of professionals with expertise in psychiatry, nursing, social work, substance abuse treatment, and employment counseling. A small staff-to-patient ratio — 10 to 12 staff members responsible for 100 to 120 patients — allows for individualized and comprehensive care.

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