Harvard Mental Health Letter

Assertive community treatment

Assertive community treatment (ACT) offers individualized, multidisciplinary care to the more severely mental ill, allowing them the opportunity to live and function in their communities instead of in institutions. The multidisciplinary team of professionals may plan and monitor treatment, accompany patients to medical and dental appointments, represent them at hearings, and help them manage money, pay bills, and apply for services. Patients also receive help with housekeeping, shopping, cooking, transportation, finding and keeping jobs, and obtaining housing. Team members educate the patients about mental illness, provide drug abuse counseling, and help patients cope with psychotic episodes and other psychiatric crises. They may also order, deliver, and supervise the use of medications. Most of these services are provided not in a clinic but in a patient's home or, for homeless patients, in a shelter or on the streets. The staff meets daily to coordinate its work, and at least one member is available at all times. The team takes referrals but may also reach out to patients on its own. Team members try to develop a long-term relationship with patients, following them for years if necessary, even as they pass through hospitals, jails, and homeless shelters.
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