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State Mental Health Policy: Washington State's Initiative to Disseminate and Implement High-Fidelity ACT Teams

Mr. Bjorklund, Mr. Reed, and Mr. Toulon are affiliated with the State of Washington Department of Social and Health Services, Health and Recovery Services Administration, Mental Health Division, 1115 Washington St., Olympia, WA 98504 (e-mail: bjorkrw{at}dshs.wa.gov). Dr. Monroe-DeVita is with the Washington Institute for Mental Health Research and Training, University of Washington, Seattle. Dr. Morse is with Community Alternatives, Inc., St. Louis, Missouri. Fred C. Osher, M.D., is editor of this column.

This column describes Washington State's historic statewide initiative to implement ten high-fidelity assertive community treatment teams. Legislative support and administrative leadership facilitated the implementation of this evidence-based practice as part of a comprehensive transformation initiative within public mental health services for people with serious mental illness. Stakeholder feedback and initial fidelity reviews suggest that the first year has been successful. Crucial strategies that were important to the teams' successful implementation, such as training and consultation, are examined. Challenges, such as staff turnover, are described along with targeted approaches that have been integral to overcoming them. Next steps to promote sustainability and implications for state mental health authorities are discussed.

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