ACT Transition Model: Development, Implementation and Outcomes in New York State

Objective: Assertive Community Treatment (ACT) was originally conceptualized as a time-unlimited service, however, more recent findings suggest that some clients can successfully recover and graduate from ACT. The NYS ACT Transition Program was developed to support transition from ACT to less intensive services and community supports. This study reports on findings used to inform model development, model implementation and early outcomes. Methods: To inform the development of the model, we conducted a series of focus groups, in-depth interviews, and secondary data analysis of discharges from ACT. Subsequently, we convened a workgroup of ACT clinicians, service recipients, experts and administrators to develop the ACT transition program. The model is a phased approach to transition, informed by Critical Time Intervention, and includes an adaptation of the Wellness Self Management curriculum. Starting in late 2009, interested was solicited from all ACT teams in New York State (n=78), and twenty-five teams agreed to participate. Participating teams received training, technical assistance and were involved in a learning collaborative to support model implementation. Results: For the teams in the initial wave of implementation (n=8), a statistically significant increase in the number of ACT team discharges for positive reasons was observed (p<0.0421). Preliminary findings regarding outcomes in the less intensive services will be discussed.