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                            Assertive Community Treatment for People with Severe Mental Illness
Developed by
	
		
			Indiana University-Purdue University Indianapolis
Indianapolis, IN
	
		March 17, 2002
Integration of services.  In most places, the social service system is fragmented, with different agencies and programs responsible for different aspects of the client’s care.  Through the multidisciplinary team, the ACT team provides an integrated appro
Team approach.  ACT teams have shared caseloads in which several team members are in frequent contact with each client.  The ACT team meets daily to discuss clients, problem-solve, and plan treatment and rehabilitation efforts.  The entire team has respo
Low client-staff ratios.  Client-staff ratios are small enough to ensure adequate individualization of services.  The 10:1 ratio has been frequently used as a rule of thumb.  In recent years it has been increasingly recognized that the caseload ratio nee
Locus of contact in the community.  All members of the ACT team make home visits.  Most contacts with clients and others involved in their treatment (such as family members) occur in clients’ homes or in community settings, not in mental health offices.
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Page 1

Assertive Community Treatment for People with Severe Mental Illness

Developed by

Gary R. Bond

Indiana University-Purdue University Indianapolis

Indianapolis, IN

March 17, 2002

Developed for

Behavioral Health Recovery Management Project
An Initiative of Fayette Companies, Peoria, IL; Chestnut Health Systems,

Bloomington, IL; and the University of Chicago Center for Psychiatric Rehabilitation

The project is funded by the Illinois Department of Human Services’
Office of Alcoholism and Substance Abuse.

Author: Gary R. Bond is Chancellor’s Professor of Psychology at Indiana
University Purdue University Indianapolis. For the past 23 years he has
conducted research on the effectiveness of psychiatric rehabilitation, often
collaborating with state departments of mental health and provider
organizations. One main research interest has been in assertive community
treatment; his publications include 40 articles in this area. Contact him at:
Department of Psychology, Indiana University-Purdue University
Indianapolis, 402 North Blackford Street, Indianapolis, IN 46202-3275.
(Phone: (317) 274-6752, Fax: (317) 274-6756, email: [email protected])

Page 13

Assertive Community Treatment Page 13

Mellman, T. A., Miller, A. L., Weissman, E. M., Crismon, M. L., Essock, S. M., &
Marder, S. R. (2001). Evidence-based pharmacologic treatment for people with severe mental
illness: A focus on guidelines and algorithms. Psychiatric Services, 52, 619-625.

Morse, G. A., Calsyn, R. J., Allen, G., Tempelhoff, B., & Smith, R. (1992).
Experimental comparison of the effects of three treatment programs for homeless mentally ill
people. Hospital and Community Psychiatry, 43, 1005-1010.

Mueser, K. T., Bond, G. R., Drake, R. E., & Resnick, S. G. (1998). Models of
community care for severe mental illness: A review of research on case management.
Schizophrenia Bulletin, 24, 37-74.

Neale, M. S., & Rosenheck, R. A. (2000). Therapeutic limit setting in an assertive
community treatment program. Psychiatric Services, 51, 499-505.

News & Notes. (1999). President Clinton announces an array of initiative at First
White House Conference on Mental Health. Psychiatric Services, 50, 980-981.

Phillips, S. D., Burns, B. J., Edgar, E. R., Mueser, K. T., Linkins, K. W., Rosenheck,
R. A., Drake, R. E., & McDonel Herr, E. C. (2001). Moving assertive community treatment
into standard practice. Psychiatric Services, 52, 771-779.

Rosenheck, R., & Dennis, D. (in press). Time-limited assertive community treatment
(ACT) for homeless persons with severe mental illness.

Rosenheck, R., Morrissey, J., Lam, J., Calloway, M., Johnsen, M., Goldman, H.,
Randolph, F., Blasinsky, M., Fontana, A., Calsyn, R., & Teague, G. (1998). Service system
integration, access to services, and housing outcomes in a program for homeless persons with
severe mental illness. American Journal of Public Health, 88, 1610-1615.

Rothbard, A. B., Kuno, E., Schinnar, A. P., Hadley, T. R., & Turk, R. (1999). Service
utilization and cost of community care for discharged state hospital patients: A 3-year
follow-up study. American Journal of Psychiatry, 156, 920-927.

Ryan, C. S., Sherman, P. S., & Bogart, L. M. (1997). Patterns of services and
consumer outcome in an intensive case management program. Journal of Consulting and
Clinical Psychology, 65, 485-493.

Salyers, M. P. (1997). Predictors and consequences of staff burnout: A longitudinal
study of assertive community treatment case managers. Unpublished dissertation, Indiana
University-Purdue University Indianapolis, Indianapolis.

Salyers, M. P., Bond, G. R., Teague, G., Cox, J., Smith, M., Hick, M., & Koop, J.
(submitted). An empirical approach to defining accreditation standards for assertive
community treatment programs.

Salyers, M. P., Masterton, T. W., Fekete, D. M., Picone, J. J., & Bond, G. R. (1998).
Transferring clients from intensive case management: Impact on client functioning.
American Journal of Orthopsychiatry, 68, 233-245.

Sherman, P. S., & Ryan, C. S. (1998). Intensity and duration of intensive case
management services. Psychiatric Services, 49, 1585-1589.

Solomon, P. (1992). The efficacy of case management services for severely mentally
disabled clients. Community Mental Health Journal, 28, 163-180.

Solomon, P., & Draine, J. (1995). One-year outcomes of a randomized trial of case
management with seriously mentally ill clients leaving jail. Evaluation Review, 19, 256-273.

Steadman, H. J., Deane, M. W., Morrissey, J. P., Westcott, M. L., Salasin, S., &
Shapiro, S. (1999). A SAMHSA research initiative assessing the effectiveness of jail
diversion programs for mentally ill persons. Psychiatric Services, 50, 1620-1623.

Stein, L. I. (1988). "It's the focus, not the locus." Hocus-pocus! Hospital and
Community Psychiatry, 39, 1029.

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