Evidence-Based Practices: Shaping Mental Health Services Toward Recovery

Implementation Resource Kit User's Guide

Acknowledgments

The Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) is a proud sponsor of this implementation resource kit for Assertive Community Treatment. As the federal agency responsible for promoting the quality, availability, and accessibility of services for people with mental illness, CMHS is responsible for identifying treatments for mental illness that work. The materials in this resource kit document the evidence for the effectiveness of Assertive Community Treatment and provide detailed information to help communities to implement the practice in real world settings. During development of the implementation resource kit, we placed special emphasis on 1) strengthening the consensus-building process, 2) expanding the involvement of consumers and families, 3) including practical orientation to issues involving service organization and financing, and 4) insisting on paying careful attention to issues of ethnic and cultural sensitivity and overall cultural competence. We are well pleased with the result.

Many other organizations contributed to developing this implementation resource kit. This broad coalition of researchers, providers, administrators, policy makers, consumers and family members, gives the resource kit its strength and vitality. We are especially appreciative of the support provided by The Robert Wood Johnson Foundation that sponsored the early stages of the Project, when evidence-based Assertive Community Treatment was identified as a practice ready for widespread implementation. We agreed. Assertive Community Treatment is critical for many persons with serious mental illness because it provides for comprehensive, structured services and supports in a community setting. It is supported by over 25 years of research, yielding a strong evidence base with generalizability to a variety of settings. With the Olmstead decision by the Supreme Court in 1999, community integration has been put into the forefront of mental health systems planning. The Assertive Community Treatment model is synonymous with moving persons with severe and persistent mental illness from institutionalized or more restricted settings of care toward more independent and community-based systems of care.

This implementation resource kit reflects the current state-of-the-art concerning evidence-based Assertive Community Treatment. It addresses both the “key ingredients” of the clinical model and many practical considerations essential for successful implementation. It also describes the need for each community to adapt the model to its particular needs and characteristics. Careful attention to unique community needs, coupled with fidelity to the key ingredients of the practice, equals successful implementation. The closer the kit user comes to following the implementation resource kit guidance, the more likely the practice will yield good results for consumers.

As mental health services research and evaluation progress, CMHS hopes to support the development of implementation resource kits for additional evidence-based practices, and to refine this and other previously-developed resource kits to take new evidence into account. Indeed, evaluation of planned pilot projects for implementing this resource kit and associated implementation strategies will tell us much about how to make improvements in future versions. We hope that this and other evidence-based practice implementation resource kits will be helpful to communities across the nation as they strive to provide the most effective services possible for persons suffering from mental illness.

This document is part of an evidence-based practice implementation resource kit developed through a contract (no. 280-00-8049) from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS) and a grant from The Robert Wood Johnson Foundation (RWJF). These materials are in draft form for use in a pilot study. No one may reproduce, reprint, or distribute this publication for a fee without specific authorization from SAMHSA.

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