Editor Lisa Dixon and the Early Career Psychiatrist Advisory Committee offer curated collections from the rich resource of articles published in the journal. Updates will focus on one area, summarizing for the researcher, clinician, and policy analyst the latest information and seminal research with links to specific content from Psychiatric Services.
Many individuals with severe mental illness benefit from intensive support, which helps them to succeed in the community. Now 50 years since its inception, assertive community treatment (ACT) remains a standard approach for reducing recurrent use of hospital services, improving community functioning, and maintaining treatment engagement. In ACT, advantages may be bidirectional; patients benefit from working closely with a specialized, multidisciplinary team, and the care team often develops a camaraderie as they provide excellent, person-centered, team-based care. A demand for services that exceeds the limited availability of ACT has led to considering readiness for transition from ACT to increase turnover rates while sustaining individuals’ recovery (versus a model of lifelong enrollment), as well as intentional adaptations to the model to serve larger caseloads and promote efficiency (e.g., flexible ACT). Other adaptations have included developing additional expertise and adding model components to best treat specific populations.
The first section of this collection provides an overview of the staff experience, structure, advantages, and challenges of ACT. The second section examines recent care trends, including a decline in ACT availability across the United States and potential solutions for a more equitable distribution of services. The third section explores potential models for primary care integration in ACT. The final section highlights adaptations to optimize program effectiveness for specific populations, including the elderly population, persons experiencing housing instability, and forensically involved individuals.
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