What is Assertive Community Treatment (ACT)?

ACT OAR 309-019-0105 (17) “Assertive Community Treatment (ACT)” means an evidence-based practice designed to provide comprehensive treatment and support services to individuals with serious and persistent mental illness. ACT is intended to serve individuals who have severe functional impairments and who have not responded to traditional psychiatric outpatient treatment. ACT services are provided by a single multi-disciplinary team, which typically includes a psychiatrist, a nurse, and at least two case managers and are designed to meet the needs of each individual and to help keep the individual in the community and out of a structured service setting, such as residential or hospital care. ACT is characterized by the following: Low client to staff ratios, providing services in the community rather than in the office, Shared caseloads among team members, Twenty-four-hour staff availability, Direct provision of all services by the team (rather than referring individuals to other agencies), and Time-unlimited services.”

ACT ADMISSION CRITERIA:

Individuals referred to the ACT program must meet all the following criteria:

OAR 309-019-0225 (26) “Serious and Persistent Mental Illness (SPMI)” means for the ACT program, the diagnostic eligibility from current DSM criteria for at least one of the following conditions, as a primary diagnosis for an adult 18 years of age or older:

• Schizophrenia and other psychotic disorders or
• Major depressive disorder or
• Bipolar disorder or
• Anxiety disorders limited to obsessive compulsive disorder (OCD) and Post Traumatic Stress Disorder (PTSD) or
• Schizotypal personality disorder.

Individuals with a primary diagnosis of a substance use disorder, intellectual developmental disabilities, traumatic brain injury, personality disorder, or an autism spectrum disorder are not the intended recipients of ACT.

Participants with significant functional impairments as demonstrated by at least one of the following conditions:

• Significant difficulty consistently performing the range of practical daily living tasks required for basic adult functioning in the community.

Impairment is demonstrated by one or more of the following:

1. caring for personal business affairs
2. obtaining medical, legal, and housing services
3. recognizing common dangers or hazards
4. meeting nutritional needs
5. maintaining personal hygiene) or
6. persistent or recurrent difficulty performing daily living tasks except with significant support or assistance from others such as friends, family, or relatives

• Significant difficulty maintaining consistent employment at a self-sustaining level or significant difficulty consistently carrying out activities needed for independent living(e.g., household meal preparation, washing clothes, budgeting, or child-care tasks and responsibilities).
• Significant difficulty maintaining a safe living situation (e.g., repeated evictions or loss of housing).
• Participants with one or more of the following problems, which are indicators of continuous high service needs (e.g., greater than eight hours per month):
• High use of acute care psychiatric hospitals or emergency departments for psychiatric reasons, including psychiatric emergency services as defined in OAR 309-023-0110(18)(e.g., two or more readmissions in a six-month period).
• Intractable (e.g., persistent, or very recurrent) severe major symptoms, affective, psychotic, suicidal.
• Coexisting substance use disorder of significant duration (e.g., greater than six months).
• High risk or history of criminal justice involvement (e.g., arrest, incarceration).
• Significant difficulty meeting basic survival needs, residing in substandard housing, homelessness, or imminent risk of becoming homeless.
• Residing in an inpatient or supervised community residence in the community, and clinically assessed to be able to live in a more independent living situation if intensive services are provided or requiring a residential or institutional placement if more intensive services are not available.
• Difficulty effectively utilizing traditional office-based outpatient services

NARA NW ACT Team currently serves all of Multnomah County and has limited coverage in Washington and Clackamas Counties. Please see coverage areas  below:

• All of Multnomah County
• Clackamas County; the following zip codes: 97222, 97086, 97015, 97267, 97027.
• Washington County; the following zip codes: 97077, 97225, 97005, 97008, 97223.