National Alliance on Mental Illness
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Two Models of Care:  A Comparison Between Assertive Community Treatment (ACT)
And Community Mental Health Center (CMHC) Services

ACT Model CMHC Model
Treatment Base In the community In a clinic
Continuity of Care Team follows client through hospital, legal, health, and social service systems Individual therapist or case manager may be less likely to follow client through health and social service systems.

10 staff for every 100 clients. 
The individual with mental illness is a client of the ACT team. 

1 staff for every 30-50 clients.  The individual with mental illness is a client of one staff member.
Staff Structure

Multidisciplinary team provides integrated clinical and case management services. 

Multiple providers function fairly autonomously, often at scattered sites.
Emergency Treatment

Team available 24 hours/day with mobile crisis intervention services.

Hospital emergency room or crisis intervention by telephone.
Frequency of Contact with Client

Daily if needed

Weekly to monthly or less.
Frequency of Family Contact

As needed

Responsibility for Medication

Home delivery by team if needed.

Client or family
Responsibility for Physical Health

Actively monitored by ACT team.

Health care use encouraged
Responsibility for Substance Abuse Treatment

ACT team itself provides substance abuse treatment.

Referred to substance abuse treatment providers.
Responsibility for Vocational Rehabilitation

ACT Team staff provide direct support in all phases of employment.

Psychosocial programs.
Responsibility for Housing

ACT Team staff

Usually client and family

Adapted from Duke University Department of Psychiatry and the Alliance for the Mentally Ill of Iowa
By the NAMI ACT Technical Assistance Center
This material was developed with support from the U.S. Substance Abuse and Mental Health Services Administration,
Center for Mental Health Services, Community Support Branch, through grant #SM52570-04