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Transitions from Assertive Community Treatment Among Urban and Rural Teams: Identifying Barriers, Service Options, and Strategies

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Abstract

An emerging focus of Assertive Community Treatment (ACT) teams is the transition of clients to less intensive services, which creates space for individuals in need of ACT and is consistent with a recovery orientation of treatment. However, there is limited research on team transition rates, post-ACT services, and strategies to overcome transition barriers. In addition, few studies have examined differences in these factors among urban and rural ACT teams. To address these knowledge gaps, we interviewed eight ACT teams in urban and rural areas of eastern Ontario regarding their transition rates, processes of transitioning ACT clients to less intensive services, transition barriers, and solutions to overcoming these barriers. On average, teams transitioned about 6% of their clients over our 3-year study period. Urban and rural teams described both similar and distinct clinical and systemic barriers, such as client reluctance to transition and finding psychiatric follow-up outside of ACT. Implications for ACT practice and policy are discussed.

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Acknowledgements

The Community Mental Health Program of The Royal would like to thank all Champlain LHIN ACT team members, managers, and directors who provided information for this study; they have been essential in sharing information to learn about client transition practices. Thank you to Robin Pow, Director of the Community Mental Health Program of The Royal and Chair of the Eastern Ontario ACTT Network, for facilitating the conduction of this study.

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Authors and Affiliations

  1. Community Mental Health Program, The Royal Ottawa Health Care Group, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada

    Andrea M. LeFebvre, Bill Dare & Susan J. Farrell

  2. Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada

    Susan J. Farrell

  3. School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA

    Gary S. Cuddeback

Authors
  1. Andrea M. LeFebvre
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  2. Bill Dare
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  3. Susan J. Farrell
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  4. Gary S. Cuddeback
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Correspondence to Andrea M. LeFebvre.

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LeFebvre, A.M., Dare, B., Farrell, S.J. et al. Transitions from Assertive Community Treatment Among Urban and Rural Teams: Identifying Barriers, Service Options, and Strategies. Community Ment Health J 54, 469–479 (2018). https://doi.org/10.1007/s10597-017-0162-3

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  • DOI: https://doi.org/10.1007/s10597-017-0162-3

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