Assertive Community Treatment (ACT)

What is assertive community treatment?

Assertive community treatment (ACT) is for people with severe mental health conditions that involves a range of treatment and support services. A dedicated team of experts works together to provide these services, including:

• Psychologists.
• Psychiatrists.
• Social workers.
• Dual diagnosis treatment specialists.
• Case managers.
• Registered nurses.

Your care team will establish a close relationship with you and work together closely. They’ll provide personalized and holistic support for you at home and within your community rather than in an institutional or hospital (inpatient) setting. The overall goals are to help you manage the mental health condition and set you up for success within your community, whether that involves help with housing, work, transportation or other needs.

There’s a version of ACT called forensic assertive community treatment (FACT). It’s for people with serious mental health conditions who’ve been arrested and/or incarcerated. “Forensic” in this case means “involving the legal system.”

Who would benefit from assertive community treatment?

Assertive community treatment is designed for people with severe mental health conditions who are most at risk of:

• Psychiatric crisis resulting in hospitalization.
• Being impacted by the criminal justice system.
• Being unhoused (experiencing homelessness).

This may include people with schizophrenia spectrum disorders, like:

• Schizophrenia.
• Schizotypal personality disorder.
• Delusional disorder.
• Schizophreniform disorder.
• Schizoaffective disorder.

ACT can help people with other kinds of mental health conditions as well, like bipolar disorder or borderline personality disorder.

How does assertive community treatment work?

Assertive community treatment is customizable and personalized, so there are several versions. But in general, the core components of ACT include:

• Home-based assessment, training and support that’s tailored to your needs and goals.
• A team of experts who can offer 24/7 assistance.
• Supporting your independence, rehabilitation, community integration and treatment adherence.
• A focus on recovery and making decisions together.
• A holistic approach to community-based services.

Your team of specialists will offer community-based services depending on your needs and goals. These may include:

• Mental health treatment, which often involves medication and psychotherapy (talk therapy).
• Substance use disorder treatment, with a focus on dual diagnosis treatment.
• Help managing other health conditions.
• Educating your family about the mental health condition (psychoeducation).
• Other family support services, like help finding childcare.
• Assistance applying for health insurance plans and food assistance.
• Housing services.
• Employment services.
• Financial management services.
• Educational support.
• Grocery shopping support.
• Public transportation.
• Incarceration rehabilitation.

The ACT team of experts typically has a small caseload, meaning they have a limited number of clients so they can focus on your care.

Is assertive community treatment effective?

Several studies show that assertive community treatment is effective at:

• Reducing psychiatric hospital admissions.
• Reducing the length of stay during hospital admissions.
• Improving quality of life.
• Improving treatment adherence.
• Reducing rearrests and incarcerations (especially with FACT programs).

How long does assertive community treatment last?

The length of assertive community treatment varies based on your specific needs and goals. But it typically lasts for at least several months. And you may want or need ACT more than once throughout your lifetime.

Your ACT team will work with you to determine which services will help you most. Together, you’ll come up with a plan to put the treatment into action.

How do I find an assertive community treatment program?

The availability of assertive community treatment programs may vary depending on where you live. There may be government-funded programs or private mental health centers that offer this treatment. If you’re interested in ACT, reach out to a healthcare provider or mental health professional. They can help guide you to a program.