Mental health courts and forensic assertive community treatment teams as correctional diversion programs

2017 ◽  
Vol 35 (5-6) ◽  
pp. 501-511 ◽  
Author(s):  
Jacqueline Landess ◽  
Brian Holoyda
Keyword(s):  
Mental Health ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Diversion Programs ◽  
Mental Health Courts

Cost-effectiveness of assertive community treatment for homeless persons with severe mental illness

1999 ◽  
Vol 174 (4) ◽  
pp. 346-352 ◽  
Author(s):  
Anthony F. Lehman ◽  
Lisa Dixon ◽  
Jeffrey S. Hoch ◽  
Bruce Deforge ◽  
Eimer Kernan ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Effectiveness ◽  
Severe Mental Illness ◽  
Usual Care ◽  
Assertive Community Treatment ◽  
Cost Effective ◽  
Homeless Persons ◽  
Community Treatment ◽  
Stable Housing

BackgroundHomelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed.AimsTo evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland.MethodsA total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed.ResultsCompared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0. 58 in favour of ACT. Patterns of care and costs varied according to race.ConclusionACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.

scholarly journals The Greek Hybrid Version of the Assertive Community Treatment Model: A Perspective View between Challenges and Limitations

Psych ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 792-799
Author(s):  
Vaios Peritogiannis ◽  
Fotini Tsoli
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Professionals ◽  
Assertive Community Treatment ◽  
Rural Areas ◽  
Community Treatment ◽  
Community Mental Health Service ◽  
Perspective View

The Assertive Community Treatment (ACT) model of care has been long considered to be effective in the management of patients with severe mental illness (SMI) in most Western countries. The implementation of the original ACT model may be particularly challenging in rural and remote communities with small and dispersed populations and lack of adequate mental health services. Rural programs may have to adapt the model and modify the ACT fidelity standards to accommodate these limitations, and this is the rationale for the introduction of more flexible, hybrid ACT models. In rural Greece, the so called Mobile Mental Health Units (MMHUs) are well-established community mental health services. For patients with SMI that have difficulties engaging with treatment services, the new hybrid ACT model has been recently launched. The objective of this manuscript is to present the recently launched hybrid ACT model in rural areas in Greece and to explore the challenges and limitations in its implementation from the experience of a team of mental health professionals with ACT experience. Referral criteria have not been strictly set, but the number of previous relapses and hospitalizations is taken under consideration, as well as the history of poor treatment adherence and disengagement from mental health services. The main limitation in the implementation of the hybrid ACT service is that it has been introduced in several areas in the absence of a pre-existing community mental health service. This may impact referrals and limit focus on the difficult cases of patients with SMI, thus making the evaluation of the model inapplicable.

Diversion programs and alternatives to incarceration

2015 ◽  
Author(s):  
Merrill Rotter ◽  
Virginia Barber-Rioja
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Public Safety ◽  
Clinical Success ◽  
Public Mental Health ◽  
Diversion Programs ◽  
Jail Diversion ◽  
Mental Health Courts ◽  
Alternatives To Incarceration ◽  
The Individual

Decreasing the number of individuals with mental illness in the criminal justice system remains a public mental health priority – one that has even reached the U.S. Supreme Court. Diverting individuals with mental illness from jail or prison decreases their exposure to that traumatic environment and addresses security concerns of corrections professionals charged with their care and management. When diversion is coupled with the court-based, problem-solving approach of monitored care and treatment in the community, public safety is improved and the clinical success of the individual is enhanced. When treatment in the community includes an explicit focus on criminogenic factors, the ability to meet public safety goals are enhanced even further. Given these several goals, as well as the considerable variability from jurisdiction to jurisdiction in court resources, treatment resources, social supports, political philosophies, and fiscal realities, the types of diversion that will work for one community may not work for another. However, the overwhelming majority of the data is clear that diversion can be implemented with documented success in the domains described above, and that there are a number of beneficial models for client intercept and associated programming. This chapter reviews the major models used to divert those with serious mental illness from incarceration, paying attention to some of the legal and clinical issues that arise as a result of diversion initiatives. Brief overviews of those interventions, including drug and mental health courts, jail diversion programs, and alternatives to incarceration for the mentally ill, are presented.

Computers and process description for community mental health care

1997 ◽  
Vol 6 (S1) ◽  
pp. 81-90
Author(s):  
Rob Bale ◽  
Matthew Fiander ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Case Management ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Assertive Community Treatment ◽  
The United States ◽  
Community Treatment ◽  
Practice Characteristics

The focus of mental health care has seen a significant shift from institutional care to community based care and has been well described (Thornicroft & Bebbington, 1989). This shift has necessitated the development of new and flexible models for ensuring that patients' needs are met. Mental health professionals have to operate across a wide range of community contexts dealing with a complex range of needs. Intensive Case Management (ICM) also known as Assertive Community Treatment is a model of service provision to the long term mentally ill in the community. The Programme of Assertive Community Treatment (ACT) developed by Stein & Test (1980) in the United States has a number of Key elements (figure 1).ACT-based ICM is unusual in that it has been extensively researched (principally in the United States of America), and programmes are relatively well described. Such descriptions, especially of programmes outside America, often focus on underlying principals and philosophies and do little to measure practice. Teague et al. (1995), however, devised clear criteria for measuring practice components and McGrew et al. (1994) asked ACT “experts” to rate the “key” elements of PACT and related a number of these to levels of hospital use. In the United Kingdom, Thornicroft (1991) listed twelve axes for describing the central practice characteristics of case management (a broad concept including ICM). These UK ‘practice characteristics’ also focus more on macro-level programme description rather than on the practices of programme staff. There is a pressing need for research into exactly what teams do.

scholarly journals A visitor's view of Madison's Program for Assertive Community Treatment (PACT)

1989 ◽  
Vol 13 (7) ◽  
pp. 352-355 ◽  
Author(s):  
M. Muijen ◽  
G. McNamee
Keyword(s):  
Mental Health ◽  
Assertive Community Treatment ◽  
Community Care ◽  
Research Programme ◽  
Community Treatment ◽  
Positive Research ◽  
Schizophrenic Patients ◽  
Research Findings ◽  
Long Term Prognosis ◽  
The Uk

Before commencing work on the Daily Living Programme at the Maudsley Hospital, in London, to compare the benefits of community care with standard hospital admission for patients with serious mental illness, a visit to Madison was arranged, where some ten years ago a similar study had been carried out (Stein & Test, 1980). We had the impression from the substantial literature which has appeared on the mental health service in Madison (Stein & Test, 1985) that they have implemented in practice their positive research findings on community care. It was felt that their lengthy experience with such a service could be beneficial to the UK, where such services are now being developed. This visit included PACT (Program for Assertive Community Treatment); a research programme investigating the long-term prognosis of mainly schizophrenic patients, and the various units of the mental health services in Madison.

Adapting the assertive community treatment (ACT) for the needs of different communities: A comparative case study of KUINA ACT Japan and Mt. Sinai ACT Canada

2017 ◽  
Vol 41 (S1) ◽  
pp. S605-S605
Author(s):  
W. Chow ◽  
M. Shiida ◽  
L. Andermann
Keyword(s):  
Mental Health ◽  
Assertive Community Treatment ◽  
Demographic Data ◽  
Emergency Admission ◽  
Community Treatment ◽  
Comparative Case Study ◽  
Mental Health Systems ◽  
Target Populations ◽  
Competing Interest

In this e-poster, we will present the assertive community treatment (ACT) model in both Japan and Toronto, Canada. We will compare the adaptations of ACT models in both teams in order to serve their target populations efficiently and effectively.We will also compare the demographic data, clinical data and the outcomes of both ACT teams by analysing the hospitalisation days, number of emergency admission and the number of admissions into hospitals.We will also highlight differences in the mental health systems in Japan and Canada.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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