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Assertive Community Treatment — Introductory video

Assertive Community Treatment — Introductory video


(onscreen text) Numerous people contributed to the development of this DVD. The video was produced by the New Hampshire-Dartmouth Psychiatric Research Center under contract number 280-02-8070 with the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS). Neal Brown and Crystal Blyler served as
the lead Government Project Officers. The views, opinions, and content of
this video are those of the producer and do not necessarily reflect the views,
opinions, or policies of SAMHSA or HHS. All material appearing in this video is in the public domain and may be reproduced or copied
without permission from SAMHSA. Citation of the source is appreciated. However, this video may not be reproduced or distributed for a fee without the specific written authorization
of the Office of Communications, SAMHSA, DHHS. For additional free copies of this video please call SAMHSA’s
National Mental Health Information Center at 1-800-789-CMHS or
1-866-889-CMHS (TTD). Originating Office Division of Service and Systems Improvement, Center for Mental
Health Services Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road, Rockville, Maryland 20857, Produced 2005 National Implementing Evidence-based Practices Project Assertive Community Treatment, Introductory Video Assertive Community Treatment
is an extensively tested treatment for serious and persistent mental illness. The program featured in this video is just one of the many throughout the U.S., Canada, England, and Australia. ♪ Music ♪ I went to a Judy Collins concert
with my mother and I had a great time. So that shows you … and I went to Charlotte and
saw Heart and had a good time. So that shows you that I can get out
and I can be a part of the community. I just want to be a part
of the community like… like everybody else. ♪ singing ♪ (Tell us what that was.) That’s (inaudible) Bolero. There are some famous people over the
years who have had mental illness too. And they’ve learned to
cope with mental illness. And I just want to cope with mine. And live out a good life. ♪ Music ♪ This South Carolina native who we
will call simply Jimmy has been struggling to cope with his schizo-effective illness for over two decades. I went through a lot of hospitalizations. I went through thirty or
more hospitalizations. I’ve been diagnosed
paranoid schizophrenic, borderline psychosis. And I’ve been diagnosed manic depressive. And I think I have a brain disorder caused
by a chemical imbalance in the brain. Before he was stabilized, in
part with the help of medication, Jimmy’s thoughts tortured him. He heard voices, suffered from
delusions and fits of temper and sometimes devastating self-destructive impulses. ♪ Music ♪ Jimmy’s mother Jessie. You know, you get up in
the middle of the night. The lights would all be on. The TV would be blaring. And things that maybe
don’t sound that bad. But when you have to live with it. This is relaxing. Oh, my gosh. I’m thinking about getting a great … putting that picture
that I have right there, that I have right there, up in
this room to add a little more color. Thanks to a program for assertive
community treatment called PACT, Jimmy now lives in his
own one bedroom apartment. He just seems to be much more stable. Now he does his
shopping and does his cooking. But he can … he calls me up and
tells me he’s cooking this. And he still … to me, he’s very
dependent on someone though. He needs that person to help him. Jim, good morning. How are you? Okay. Are we ready to do some grocery shopping? I want you to go through your refrigerator
and look in your freezer and check real carefully and make up a
grocery shopping list. You got your list? In Outreach, a PACT model, staff spend
about five hours a week with Jimmy in multiple contacts. A melding of support,
teaching, problem solving, and therapy. ♪ Music ♪ I see nothing. For me nothing. Patty, she gets her medication
Monday through Thursday today. And she has a one-to-one with Andrea. And we give her a phone call at night to
remind her to take her evening medicines. It’s a non-traditional approach. Rather than individual caseloads,
typical with most mental health clinics, the team shares total responsibility
for the entire client population. The team of ten mental health professionals meets daily to review each client. But most of the direct client
work goes on outside of the office. Good morning. I’ve got a present for you. This is your casement. It’s a kind of therapy to go
where no problem is too much. PACT director Barbara Julius. What makes mental health might not
just be a visit to your psychiatrist. It might also mean having
your entitlements in place. Or it might mean having
your rent paid on time. It might be knowing how
to go grocery shopping. So instead of meeting with a person
and talking about how they’re doing, how they feel once a
month or twice a month, what we do is everything that it takes
to keep people in the community living independently. Providing assistance
with social relations, employment and basic
needs like housing and food. That corn looks pretty good. What’s the price on that? Seventy-nine. That’s not bad for three fresh ears. Treatment strategies are
tailor made for each client, including facilitating health care. I’ll be right behind you. Over the years, clients
remain in the program, even though their need
for services may fluctuate. Some people come in the program
needing all of those services, needing three or four staff
interacting with them on a daily basis. Lots of phone call support, lots
of emergency crisis intervention. And as they see that
support there, they get better. So that people who once were
in this program needing three, four, five interventions a day every
day, might at this point come in weekly for a med refill. We don’t fire people
when they get too sick. You know, that’s a key point for us. But we keep them all. They’re all here. And we take
responsibility for that treatment. And really are willing to try almost
anything that it will take to support them in getting better. This holistic treatment concept
with its shared team responsibility, hands-on individualized service and
lifetime commitment to clients makes assertive community treatment unique. It’s extremely rewarding for me. Because I can see changes. I can see the impact that we’re having. I know that what I do each day
really makes a big difference. That’s why I’m here. I do it because it’s worth doing. My mother raised the seven of us, right, my mother (inaudible) The intensity of involvement
with clients demands a low staff to client ratio, one staff to ten or twelve clients. Low staff ratios pay off, reducing inpatient hospital days by as much as 85 percent. Reduced hospital
admissions mean fewer crises. But because of the close contact
and constant availability of staff, when a crisis does erupt, the client gets the benefit of early personalized intervention. He was okay during
the evening last night. He was threatening
yesterday to break the windows out. And he’s still saying the
same complaints from yesterday, that the pressure’s on. (The voices are worse?)
The voices are worse. That’s what’s happening. And he’s been working up to
this over the last ten days. I don’t know what I’m going to do. I have to do something. I just can’t stand going on. That means I’ll hurt myself if I
don’t hurt somebody or something. It’s a rough road for
clients and families in crisis, sometimes involving the
court, the police or sheriff, neighbors and landlords, hospital
emergency room personnel and 911. Not with PACT. The team handles it all. ♪ Music ♪ With the nurse’s guidance, clients prepare their own medication for the week. And all staff share in making daily,
morning and evening medication deliveries for those who need it. All right. You take that. And you take this. Nice and cold too. I already feel like I’m whistling Dixie. (You do?) You lowered your Deprocote? Yeah. I used to take three Deprocotes
at night, now I only take two. Any reason he did that? Memory. Your memory? To increase it? No, to decrease it. To decrease your memory? No, (laughing) I mean to
make my memory come back. Okay. I get paranoid. I think people are after me. I think little creatures are bothering me. And I see things on the
floor or on the ceiling. I don’t see them anymore. If I take my medicine, I’m fine. If I don’t take them, I get
sick and I end up in the hospital. And tell me why you’re
taking the Deprocote. Deprocote is for mood swings. And the Meleril is for clear thinking. When you spoke to Dr. Christie last,
you said that you weren’t hearing voices. No, I wasn’t hearing voices. I’m just having a hard time sleeping. I was in and out of the hospital because I couldn’t face the fact about being mentally ill. I cried a lot. I didn’t want to take my medicine. I said I don’t need this medicine. That’s not for me. This mental illness will go away. It will go away. But the mental illness,
schizophrenia, did not go away. Yolanda’s mother Lillian. From the time she was sixteen
until give or take eighteen, I could say on average she’s been in
the hospital about twenty or thirty times within that length of time. After she got into outreach, it was a
tremendous burden relieved off of me. Because at least they would check on her. They would make sure
she takes her medication. They would make sure if she had any place to go, to the store. And I feel so much better. ♪ Music ♪ I did pretty good in the program. I came out
and in and out of hospitals sometimes. But I have moved into my own
apartment for the first time. That’s nice. You can do what you want to
do in your own apartment. You don’t have to share
anything with nobody. If you want to walk around here
with your bra and underwear on, you walk around with
your bra and underwear on. Can I say that? (laughs) (inaudible) Now Yolanda is taking steps towards even greater independence. Studying for her GED and learning to handle her own finances with PACT team help. Can I open a bank account in the borough of Savannah (inaudible)? I can. This is delicious. This is delicious. This is delicious. ♪ Music ♪ Both Jimmy and Yolanda experience the documented benefits of PACT with fewer symptoms and hospitalizations and greater independence. That’s my favorite. That’s the guitar. That’s the ocean. That’s (inaudible) that’s a rose. That’s a rose. That’s greenery. That represents a forest. Programs for assertive community
treatment offer some comfort and hope. Are you going to be the
only signer on this account? Yes. Okay, the minimum to open
the account is fifty dollars. And then our least expensive checks
are eleven dollars and (fade out) Without outreach, I’d be back in the hospital. I know I would. Sometimes I get upset
(inaudible) about the program. But it’s best. I wish the whole country could get it. Because it would be very
good for the mentally ill. It could probably make us feel
like a whole new brand new person. A mother in her ninth
month, ready for a girl or boy, eight pounds of love, a bundle of joy. To think that a woman can have a man’s
child and that child can grow up to be a successful doctor, lawyer … Outreach gives me confidence. Because I think that
it’s given me independence. And it’s given me the
freedom to be myself. And when I’m talking
straight, I’m making sense. And when I’m making
sense, I’m making progress. And when I’m making progress,
I’m getting to meet my goals. And my goal is to be an educator. I would like to educate people that
they can do something with their lives. That there is hope. There is hope out there. And with hope comes faith, and with faith comes hope. And you can do anything you want to. If you just get your
mind in the right order, you know, you can do anything. ♪Music ♪

Comments (7)

  1. I am an ACT worker from the Detroit suburbs, and wanted to say that it's really great that this is up, so people can see how great ACT is- If you're a social worker, or in school to be- I would definately recommend it. Everyday is an adventure out in the community! Seeing clients in their own element is radically different than seeing them in an office. Also, you have the opportunity to anticipate crisis, rather than hear about it (days or weeks later) and then try to pick up the pieces.

  2. Thanks for your dedication!

  3. Thank you for your good work.

  4. Keypoint : at 7:52 – The intensity of involvement with clients demands a low staff to client ratio, one staff to ten or twelve clients.

  5. so you try to bribe them with food, only to eat it yourselves. What if you give the wrong medicine? Have you seen many deaths

  6. Pact seems to be helping these individuals in this video. I think it’s wonderful that there are programs for people with special needs.

  7. So what is the LPN job inside the team

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