Assertive Community Treatment (ACT) provides community-based behavioral health services to adults with Severe and Persistent Mental Illness living in central Nebraska, maximizing individual strengths and independence. The overall goal is to reduce and minimize psychiatric hospitalizations and inappropriate ER visits. ACT is a multidisciplinary team that is based on a national model, meets strict national standards and provides continuity of care. The team has the capacity to adjust the service intensity to a consumer, as determined by the individual’s needs at any given time. Services are available seven days a week, twenty-four hours a day, 365 days a year. Staff have scheduled hours a minimum of 12 hours per day on weekdays and 8 hours per day on weekends and holidays. ACT supports its clients by having a staff member on call at all times to provide 24-hour crisis availability and assistance via phone and/or in person if necessary. ACT offers intensive outpatient support with a focus on empowering the client to maintain the highest level of independence possible.
Target Population
The population served are individuals who reside in the Region 3 Mental Health service area and have Severe and Persistent Mental Illness (i.e., Schizophrenia, Schizoaffective Disorder, Bi-polar Disorder, and Major Depression) that seriously impairs their functioning in community living as evidenced by:
- Significant functional impairments in daily living tasks
- Inability to be consistently employed
- Inability to maintain a safe living situation
For ACT Referrals
The primary referral sources are psychiatric in-patient hospitals, as the admission criteria includes serving those who have had numerous in-patient hospitalizations. These hospitals include Lincoln Regional Center, Mary Lanning Healthcare in Hastings and Richard Young Hospital in Kearney. Other referral sources include a variety of other Behavioral Health service providers such as Community Support workers, Outpatient Psychiatrists, APRNs, therapists, probation, substance abuse dual diagnosis treatment centers or Residential Rehabilitation Services.
Admission Guidelines
- DSM diagnosis consistent with a serious and persistent mental illness
- Persistent mental illness as demonstrated by the presence of the disorder for the last 12 months or which is expected to last 12 months or longer and will result in a degree of limitation that seriously interferes with the client’s ability to function independently in an appropriate manner in two of three functional areas.
- Presence of functional deficits in two of three functional areas: Vocational/ Education, Social Skills, Activities of Daily living
a. Vocational/Education: inability to be employed or an ability to be employed only with extensive support; or deterioration or decompensation resulting in inability to establish or pursue educational goals within normal time frame or without extensive supports; or inability to consistently and independently carry out home management tasks.
b. Social Skills: repeated inappropriate or inadequate social behavior or ability to behave appropriately only with extensive supports; or consistent participation in adult activities only with extensive supports or when involvement is mostly limits to special activities established for persons with mental illness; or history of dangerous to self/others.
c. Activities of Daily Living: inability to consistently perform the range of practical daily living tasks required for basic adult functioning in 3 of 5 of the following:
1. Grooming, hygiene, washing clothes. Meeting nutritional needs
2. Care of personal business affairs
3. Transportation and care of residence
4. Procurement of medical, legal, and housing service; or
5. Recognition and avoidance of common dangers or hazards to self and possession.
Ineligibility for services: Exclusionary Guidelines
- The individual does not meet DSM Axis I diagnosis consistent with severe and persistent mental illness.
- The individual has a primary diagnosis of substance dependence/abuse or developmental disability.
- The persistent mental illness has not been present for the last 12 months or is not expected to last 12 months or longer.
- The persistent mental illness has not seriously interfered with the client’s ability to function independently in two of three functional areas.
- The individual is a resident of a nursing facility or psychiatric residential rehabilitation facility.
- The individual requires inpatient treatment services for a period exceeding 10 days. (No billing after this time, however may be considered for planned return)