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Assertive Community Treatment (ACT)

16 June 2025

Assertive Community Treatment (ACT) is a treatment and support model that provides a multidisciplinary treatment framework in the patient's living environment. The service is suitable for patients dealing with Severe Mental Illness (SMI), which significantly affects daily functioning and the ability to integrate into the community or puts them at risk of repeated psychiatric hospitalizations.

ACT's main goals

  • Disease management to reduce symptoms and achieve mental balance and stabilization.
  • Reducing the indirect negative implications of the disorder, behaviors, and risk situations.
  • Promoting daily, social, and occupational functioning.
  • Promoting recovery by strengthening the healthy parts of the patient and their identity beyond the illness.

ACT's professional team

  • Team composition: A permanent team of professionals from all areas of mental health.
  • Team roles: assessing the patient's condition at the intake, after which a treatment plan tailored to their condition is determined together with the patient. During the treatment period, the professional team monitors and adjusts the intensity of the treatment based on the patient's personal needs until the mental state stabilizes.
  • Team availability: The service model is based on the availability and accessibility of the assertive community treatment team.
  • Dealing with crisis situations: The team is prepared to provide an immediate response remotely, come to the patient's home, or refer them to the emergency room.

Assertive community treatment (ACT) is a treatment and support model that provides a multidisciplinary treatment envelope in the patient's living environment. The service is primarily suitable for population at risk of repeated psychiatric hospitalizations or acute conditions, to prevent psychiatric hospitalization.

The model is in the process of being developed and implemented in the field of mental health in most HMOs in Israel.

The main goals of assertive community treatment

  • Illness management
  • Reducing implications
  • Promoting functioning
  • Promoting recovery
  1. Optimal management of the disease: The model offers an available and accessible therapeutic framework that helps manage treatment optimally, reduce symptoms, and achieve mental balance and stabilization.
  2. Reducing the indirect negative implications of the disorder: Poor judgment or severe depression can lead to risky behaviors and situations, such as homelessness, arrests, drug use, and suicide.
  3. Promoting daily, social, and occupational functioning: Because the treatment is provided in a community setting, it allows for continuity in various areas of functioning and routine. The work of the multidisciplinary team with the patient contributes to personal empowerment, promotes independence, and supports integration into the community.
  4. Promoting recovery: The process focuses on strengthening the healthy parts of the patient and their personal identity, beyond the illness. To do so, the therapeutic team emphasizes building internal resilience, fostering relationships, and helping the patient identify personal goals, aspirations, desires, and dreams they want to fulfill.

Whom is ACT meant for?

The treatment is suitable for individuals dealing with Severe Mental Illness (SMI), which has significant effects on daily functioning and the ability to integrate into the community, or for those at risk of repeated psychiatric hospitalizations. Since the service is long-term, alongside the therapeutic component—which is the core of the service—a rehabilitative response is also provided to improve functional impairments and limitations often seen in prolonged illness.

In many cases, patients belong to at-risk populations who do not regularly attend clinic-based treatment due to their mental health condition. These individuals may need support in managing their illness and improving functioning. Community- or home-based care can help engage them in treatment, foster a sense of partnership, and enhance their ability to manage their care, which in turn promotes mental stability and helps prevent hospitalization.

Additionally, the service may be offered as a continuation of care, forming part of a gradual treatment continuum following full hospitalization, or as part of treatment in other mental health settings such as rehabilitative homes, clinics, or crisis teams.

ACT's professional team

The multidisciplinary ACT team includes professionals from all areas of mental health, such as psychiatry, nursing, psychotherapy, social work, and care coordination. Depending on the patient’s needs, additional services may be provided in areas such as occupational therapy, nutrition, speech therapy, creative arts therapies, and other relevant fields. The team often also includes peer specialists (individuals with lived experience of mental health challenges who are trained to support others), social mentors, and trained support staff who offer ongoing guidance and assistance under the supervision of the professional team.

To build the strong, consistent relationships that are essential for effective care, the team remains as consistent as possible.

One of the team members is appointed as the case manager, and serves as the treatment coordinator, and is also the central contact person who accompanies and assists in receiving the entire treatment and support.

The team assesses the patient’s condition during an intake meeting, usually held in the patient’s home. After the intake, a personalized treatment plan is developed together with the patient. This plan outlines the goals, types of treatment, team members involved, and how often meetings will take place. The team works in close coordination to meet the treatment goals.

Throughout the treatment period, the professional team monitors progress and adjusts the level of care based on the patient’s individual needs, with the goal of achieving mental and emotional stability. When treatment ends, the team holds a summary and closure meeting and coordinates next steps with community-based rehabilitation and mental health services to ensure continuity of care.

The service model is based on the availability and accessibility of the assertive community treatment team beyond the meetings. Mostly, the model includes the availability of a 24/7 on-call person or hotline throughout the entire treatment period.

In crisis situations, or when the patient's condition worsens, the team is prepared to provide immediate response remotely, and if necessary, even come to their home. In situations where it is impossible to treat within the ACT team's framework, the team will refer them to the emergency room.