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Recovery Oriented Assertive Community Treatment Teams

Recovery Oriented Assertive Community Treatment Teams. WEBINAR August 2008 Michelle P. Salyers, PhD Evette A. Blackman , MSW. Recovery: Guiding Vision of Mental Health Services. President’s New Freedom Commission on Mental Health (2003) Surgeon General’s Report (2000)

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Recovery Oriented Assertive Community Treatment Teams

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  1. Recovery Oriented Assertive Community Treatment Teams WEBINAR August 2008 Michelle P. Salyers, PhD Evette A. Blackman, MSW

  2. Recovery: Guiding Vision of Mental Health Services • President’s New Freedom Commission on Mental Health (2003) • Surgeon General’s Report (2000) • Consumer Advocates (long history)

  3. What is Recovery? • Traditional, Medical Model • “Cure,” remission of symptoms • Disability Movement/Social Recovery • Like other chronic conditions • Emphasis on functioning • Current - Consumer Accounts/Personhood • Individually defined • Themes of Hope, Personal responsibility, Meaningful lives, Community integration • Universal process

  4. What Are Recovery Oriented Services? • Help people achieve recovery outcomes • Effective (evidence-based) • Wholistic • Consumer directed • Partnerships between providers, consumers, and their supporters • Consumers as informed decision-makers

  5. Is ACT Recovery Oriented?

  6. Assertive Community Treatment • Multidisciplinary staffing • Team approach • Low client-staff ratios (10:1) • Locus of contact in the community • Intensive/frequent contacts • Assertive outreach • Ready access in times of crisis • Time-unlimited services

  7. Different Labels for Assertive Community Treatment • PACT • ACT • assertive outreach • mobile treatment teams • continuous treatment teams

  8. Initial Development of ACT(Stein & Test, 1980) • Madison Wisconsin (PACT) • Developed during 1970s • “Hospital without Walls” • Experimentally demonstrated its effectiveness

  9. Who is ACT for? Adults with Severe Mental Illness • Diagnosis: Schizophrenia spectrum, major affective disorders • Disability: Functionally impaired by the disorder • Duration: Have had the disorder for some length of time

  10. Who is ACT for? Consumers with the most severe difficulties: • Frequent psychiatric admissions • Frequent use of emergency rooms • Housing instability • Not helped by/participating in treatment • “Dual diagnosis” (SMI + substance abuse) • Problems with the law • Recent discharge from long-term hospital

  11. ACT as a Way to Organize Services… • As a model, ACT is effective at delivering structured intensive services to meet the multiple individualized needs of consumers • The original model itself was not necessarily a “recovery model” or “recovery oriented” • Developed out of a need to keep people out of the hospital • Reflected hospital staffing patterns

  12. Typical Criticisms of ACT: Are They True? • Paternalistic • Coercive • Overuse of legal sanctions • Too much emphasis/reliance on meds • Deficit model • Survival focus, not growth oriented • Non-empowering

  13. Resolution? • As a model evidence-based practice, ACT specifies the organizational structure of service delivery • Other evidence-based practices specify the clinical interventions • Integrate ACT with other identified evidence-based practices • Focus on how consumers and providers work together to make treatment decisions

  14. Recovery-Oriented ACT in Action Team Umoja Description

  15. Mailing address: ACT Center of Indiana Roudebush VA Medical Center 1481 W. 10th St. (11H) Indianapolis, IN  46202 Telephone:  317-988-3119  Email: Nancy Allen nanallen@iupui.edu For more information: Website: www.psych.iupui.edu/ACTCenter

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