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Assertive Community Treatment (ACT) for Schizophrenia

The following treatment guidelines are meant as a reference tool only, and are not intended as treatment advice or to replace the clinical decision-making process of psychiatrists or other health professionals who administer these treatments. In clinical practice there are often good reasons why treatment approaches differ from what is described here.

 

For some people with severe forms of Schizophrenia, regular case-management may not be enough to ensure that the person receives all their necessary services.   Assertive Community Treatment (ACT) is an intensive form of case-management where all necessary services are provided by one multidisciplinary team who are available to the patient 24 hours a day, 7 days a week, and who will often bring their services directly to the patient by making home visits.   ACT is clearly a very expensive form of treatment, for it requires a significant number of mental health professionals offering their services to a relatively small number of patients.  However, the main goal of ACT is to minimize the number of hospitalizations that the person requires, which would save on health care costs in the long run.  Moreover, the aim of ACT is to allow people with Schizophrenia to remain in their communities and enjoy a decent quality of life.

Studies have shown that ACT does reduce the amount of time that its clients spend in hospital and also improves their chances of remaining in a stable housing situation, especially when it is offered to the people with the most severe forms of Schizophrenia [ref].  However, this treatment has not been shown to be of much benefit in other areas, such as improving the person's social adjustment or his or her chances for obtaining employment [ref], but this may reflect the fact that the people receiving ACT tend to be those with the most severe forms of the condition.   

 

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Case-Management

Social Skills Training