The Treatment of Severe Mental Illness: An Implementation and Evaluation of Assertive Community Treatment
Keywords:Severe Mental Illness
Assertive Community Treatment
Community Mental Health Center
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Background: Patients with severe mental illness (SMI) face widespread challenges in life, including reduced life expectancy of up to 30 years less than the general population; high comorbid health conditions; lifelong prevalence of substance use disorder of 50%; more frequent hospitalizations; increased risk of homelessness; social isolation and loneliness; and reduced quality of life. Aims: The purpose of this DNP project was to evaluate the implementation of a new Assertive Community Treatment (ACT) program as the standard of care in serving a new panel of patients with SMI receiving services at Community for New Direction. Method: The Tool for Measurement of Assertive Community Treatment (TMACT) was used to evaluate the ACT program fidelity. By using this tool, the author is able to identify a “snapshot” of the ACT team structure, staffing, and practices to compare with the defined ACT model to determine program fidelity. Results: The results of the TMACT fidelity tool revealed both strengths and weaknesses of the CND ACT program. Strengths included low ratio of consumer to staff, consistency and communication during team meetings, and the team’s competency in delivering evidence-based practice of integrated dual disorders treatment. Weaknesses included the limited timeframe of the program, vacancies in team positions, and low rates of contact with natural supports. Conclusions: By using the ACT program, patients suffering from SMI were able to get the necessary team support to maintain functioning in the community. By evaluating the program fidelity, a roadmap was created to guide the quality improvement plan for the organization moving forward.