IMPLEMENTING ASSERTIVE COMMUNITY TREATMENT TEAMS

The Connecticut Department of Mental Health began creating assertive c ommunity treatment teams in 1987. The authors describe the approach ta ken by the department in defining the assertive community treatment mo del, in creating new assertive community treatment teams, and in monit oring the creation and functioning of these teams to ensure that fidel ity to the assertive community treatment model is maintained. Assertiv e community treatment teams can be created even in the absence of fund ing for new staff by reconfiguring current community-based staff and b y moving staff from state hospitals to the community. Preliminary data from a randomized trial in Connecticut comparing assertive community treatment with high-quality case management in areas with an array of community services indicated that the intended models were replicated, with variations in practice style across programs. Clients in asserti ve community treatment were in the hospital about half as often as cli ents in standard services and were also less likely to be without a pe rmanent residence. Training and ongoing monitoring of assertive commun ity treatment teams are necessary to detect practices that diverge fro m the intervention model so that corrective action can be taken.