Centerstone’s ACTion in Illinois will establish and maintain a recovery-oriented Assertive Community Treatment (ACT) program according to fidelity to improve behavioral health outcomes and support community living for adults with serious mental illness (SMI). ACTion’s multidisciplinary team will provide all ACT Core Services for 60 unduplicated focus population adults in Jersey, Madison, and St. Clair counties, Illinois (Y1: 30; Y2-3: 10/year.; Y4-5: 5/year).
ACTion’s focus population comprises an anticipated 18,029 (4.3%) catchment area adults with SMI whose demographics and socioeconomics are expected to mirror those of Centerstone’s clients with SMI, with 39% male, 62% female, 67% White, 14% Black, and 15% Hispanic/Latino individuals. An estimated 97.5% live below poverty and 15% have less than a high school diploma/ GED. ACTion will serve subpopulations from among the area’s adults who are homeless (286); are racial, ethnic, sexual, and gender minorities (e.g., 3,441 LGB and/or 4,120 racial/ethnic minorities); are criminal justice system-involved (1,457); and/or have a co-occurring mental and substance use disorder (10,555).
ACTion will be implemented according to SAMHSA’s ACT Evidence-Based Practices (EBP) Knowledge Informing Transformation (KIT), integrating strategies to ensure culturally competent, trauma-informed, and recovery-oriented care according to SAMHSA’s TIP 59: Improving Cultural Competence; TIP 57: Trauma-Informed Care in Behavioral Health Services; and the Recovery-Oriented Systems of Care Resource Guide. Additional EBPs will be integrated to complement implementation of core ACT services (e.g., evidence-based supportive therapies will include Cognitive Behavioral Therapy [CBT] and CBT for Psychosis; SUD treatment, Seeking Safety; support services, Whole Health Action Management; etc.). Key ACTion strategies/interventions include community collaborations, program standards, key plans (i.e., Training, Evaluation, Continuity of Operations/Sustainability), an Advisory Group, outreach/engagement, crisis assessment/intervention, comprehensive assessment, Individual Treatment Plans, SMI treatment/interventions, illness management and recovery, supportive therapy, substance use treatment, recovery/support services (e.g., employment and benefit assistance, activities of daily living, peer support), and case management.
ACTion’s 4 goals with measurable objectives include: Goal 1: Establish/maintain an ACT project comprising core services and characteristics, and assemble/train 8 FTEs and provide ACT core services, assessment, crisis intervention/treatment, and recovery/support services to 60 adults. Goal 2: Develop capacity to expand/maintain a comprehensive service continuum, and establish an Advisory Group comprising 20% clients/family and other stakeholders; review/refine 5 policies/procedures; expand/maintain Letters of Commitment from 20 stakeholders; conduct outreach to 500; provide basic/intensive ACT training to 9 project staff and ACT model training for 600 agency staff/community providers; develop 2 strategies to address staff turnover/cross training; and identify 2 funding mechanisms for sustainability. Goal 3: Improve client health status/outcomes, and reduce mental health symptomatology among 70% and suicide crisis among 80%; link 100% in need with employment/education; and achieve 50% with low/no problems related to substance use, 80% with no past 30-day homelessness, 80% with no past 30-day hospitalization, 60% with no past 30 day criminal justice involvement, 80% reporting functioning well in daily life, 80% with positive perception of care, at least weekly interaction among 80%, 80% knowing who to call from the ACT team, and social connectedness among 70%. Goal 4: Develop/refine a replicable service model, and report annually on a comprehensive evaluation and biannually on subpopulation disparities; collect/analyze demographic data; and produce 5 materials for dissemination/replication.