Transitions from Assertive Community Treatment to Less Intensive Services

Gary Cuddeback, Ph.D., M.S.W., M.P.H., Principal Investigator

Today, much attention is being focused on increased access to evidence-based practices and on ways in which they can be disseminated more broadly in the public mental health system for persons with severe mental illness. Assertive Community Treatment (ACT) is one of the most thoroughly studied of these practices. Since its inception in the early 1970s, the predominant thinking has been that persons who need ACT need it for life; however, this perspective is contrary to the contemporary recovery orientation and presents a challenge to mental health providers because once a team reaches capacity it is no longer a resource to the community. One way mental health agencies have dealt with this capacity problem is to transition ACT consumers to less intensive services thereby freeing capacity for other persons who need ACT. However, surprisingly little research has focused on ACT transitions and outcomes. As a result, a number of basic questions have yet to be adequately answered: Who among ACT consumers can be transitioned to less intensive services, to what level of services, and with what outcomes? This study will use both quantitative and qualitative research methods and administrative data from a large mental health provider in Cincinnati, Ohio, in order to examine and compare the experiences of 237 ACT consumers who were transitioned to less intensive services and 672 ACT consumers who were never transitioned to less intensive services. In addition, consumer interviews (n = 20) and focus groups with ACT staff (n = 25) will be conducted to understand the experiences, barriers and facilitators of consumers’ transitions to less intensive services and provide context to quantitative findings. This low-cost, high-yield study promises to provide important information for practitioners, administrators and policy makers struggling with the equitable distribution of evidence-based practices.

Related Publications:

Cuddeback GS, Wright D, Bisig NG. Characteristics of Participants in Jail Diversion and Prison Reentry Programs: Implications for Forensic ACT. Psychiatric Services 2013; 64(10):1043-1046.

Cuddeback GS, Shattell MM, Bartlett R, Yoselle J, Brown D. Consumers’ perceptions of transitions from assertive community treatment to less intensive services. Journal of Psychosocial Nursing and Mental Health Services 2013;51(8):39-45.