Comparison of Assertive Community Treatment Programs in Urban Massachusetts and Rural North Carolina
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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.
KeywordsAssertive community treatment (ACT) Mental health Rural Urban
We would like to thank: Jill Sheridan; Wendy Webber; Gail Craddock and Marge Cawley at the National Development and Research Institutes in North Carolina; the Massachusetts Department of Mental Health; and the North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services; and the team leaders from North Carolina who participated in the survey.
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