Is There a Place for Psychology in Assertive Community Treatment?

The locus of mental health care for individuals with severe and persistent mental illness continues to shift from inpatient units to outpatient and community services. Among community-based approaches, assertive community treatment (ACT) teams have demonstrated clinical and cost effectiveness in state and federal public systems. However, public sector psychologists are underrepresented on the ACT teams. This paper identifies some contributing factors and potential solutions for the current situation from the perspective of five Veterans Administration psychologists. Participants provide rationale for inclusion of psychologists on ACT teams, clarify their role with respect to clients and treatment teams, and review disincentives and benefits of psychologist participation in multi-disciplinary community services. Symposium topics include: (1) identification of reasons why psychologists are needed on ACT teams; (2) an outline of some contributions psychologists can make to the care of people with serious mental illness; (3) a description of psychologists' approaches to case management services for clients in the community; (4) highlights of the psychologist's clinical role with respect to the ACT team; and (5) discussion of some of the barriers and rewards for psychologist participation. (Contains 19 references.) (JDM)