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What is Assertive Community Treatment?

By L. Whitaker
Updated May 17, 2024
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Assertive Community Treatment (ACT) is a community-based approach to mental health services, first established in the United States in the late 1960s. An Assertive Community Treatment program provides 24-hour continual care to individuals who have severe mental illness. In contrast to a traditional case management approach, in which the client must autonomously seek assistance from a variety of office-based service providers, an Assertive Community Treatment team fulfills the client's mental health needs in community settings or the client's own home. This model takes round-the-clock care to clients whenever assistance is needed.

This approach to treatment is an interdisciplinary model of service delivery. The Assertive Community Treatment team might include social workers, counselors, nurses, psychiatrists, vocational rehabilitation specialists or other mental health professionals. The services offered by the treatment team are intended to be comprehensive, ranging from mental health assessment and counseling to substance abuse treatment or employment assistance. The Assertive Community Treatment approach seeks to improve the target population's overall functioning, to minimize the societal impact of mental illness within the local community and to provide customized, long-term services that meet the basic needs of individuals who have severe mental illness.

The Assertive Community Treatment approach is considered to be an evidence-based and clinically effective model for treating serious mental illness. It frequently is used with people who have bipolar disorder or psychotic disorders such as schizophrenia, especially those also affected by substance abuse, legal troubles or homelessness. Such individuals, who might range from those who are in their late teens to the elderly, might not have been helped effectively by previous interactions with traditional outpatient services. The ACT team uses a proactive and supportive model intended to help integrate the affected individuals back into daily functioning as productive community members. The support of the interdisciplinary team reduces the negative impact of mental illness on the individual client's family and overall community.

As of 2010, the Assertive Community Treatment approach was in use throughout the United States, Canada and England. In the U.S., an ACT program is operated by local or regional entities but must conform to principles and standards outlined by the National Alliance on Mental Illness (NAMI). Program names may vary, including Assertive Community Treatment, Program of Assertive Community Treatment, Community Support Programs or Mobile Treatment Teams. Information on the regional locations of Assertive Community Treatment programs in the United States can be obtained from NAMI.

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