Comparison of Assertive Community Treatment Programs in Urban Massachusetts and Rural North Carolina

Original Paper

DOI: 10.1007/s10488-009-0208-0

Cite this article as:
Siskind, D. & Wiley-Exley, E. Adm Policy Ment Health (2009) 36: 236. doi:10.1007/s10488-009-0208-0


In this pilot study, we compared teams in rural North Carolina (NC) and urban Massachusetts (MA) to examine the how sites vary the implementation of the Assertive Community Treatment (ACT) model to respond to state and local circumstances. We analysed and compared data on: client characteristics using the NC-TOPPS and a modified survey in MA; Regional Demographics and; Team Characteristics. Issues such as driving distances, lack of qualified clinical staff, scarcity of physicians, and more limited oversight created impediments to fidelity in rural NC, despite higher per patient funding. ACT is now national, but variability in implementation of the model remains.


Assertive community treatment (ACT) Mental health Rural Urban 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Queensland Center for Mental Health ResearchUniversity of QueenslandWacolAustralia
  2. 2.Division of Mental HealthPrincess Alexandra HospitalBrisbaneAustralia
  3. 3.Department of Health Policy and ManagementUniversity of North Carolina School of Public HealthChapel HillUSA

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