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Improving Guidance For Care Transitions For Clients Of Assertive Community Treatment (act) And Flexible Act

Award Number: K08MH142767
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2030

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Improving Guidance For Care Transitions For Clients Of Assertive Community Treatment (act) And Flexible Act - PROJECT SUMMARY Assertive Community Treatment (ACT) is a time-unlimited interdisciplinary team model of intensive outpatient care with demonstrated effectiveness for treating people with serious mental illness and complex needs such as homelessness, forensic involvement, or substance use. However, many mature ACT programs now have low turnover and long waiting lists, limiting program reach. Uncertainty about a client's future stability is a limitation to discharging clients from ACT, due to the difficulty of reestablishing care following discharge. In addition, there has been increasing interest in adoption of procedures such as tiered stepdown that allow ACT Teams to decrease service intensity without necessitating discharge from the program. The proposed study will inform efforts to reduce uncertainty around discharge practices in ACT by assessing predictors of psychiatric hospitalization following ACT discharge and by surveying ACT Teams to better understand variation in their discharge practices. The specific aims of the study are (1) to identify client characteristics that predict risk of psychiatric hospitalization during the 12 months following ACT discharge, (2) to estimate the effect of care stepdown within ACT on 12-month post-discharge psychiatric hospitalization risk, (3) to conduct a survey to understand variation in discharge resources and practices between ACT teams and correlate these differences with post- discharge outcomes. We will address these aims by linking data for the over 22,000 current and previous ACT participants across New York State Medicaid and the Child and Adult Integrated Reporting System (CAIRS), an administrative database collected every 6-months by ACT Teams. CAIRS data provide a rich set of covariates including client demographics, diagnoses, social factors including employment, housing and forensic status, and client risk factors including history of self-harm, suicide attempt, or violence, and reason for discharge. Medicaid data provide information on care intensity, antipsychotic prescription possession, outpatient, emergency department, and inpatient mental health service utilization. Interpretable prediction models such as LASSO will be used to predict post-discharge outcomes. A survey of New York State ACT Teams leaders will be fielded to assess variation in discharge-related resources (e.g. referral clinic availability), adherence to ACT transition manual best practices, and referral constraints. This new information will guide improvements in ACT discharge procedures.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $195,804 )
2026	2026	RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.	1051 RIVERSIDE DR	NEW YORK	NY	10032	NEW YORK	USA	Mental Health Research Grants	000	1	9/2/2026	NEW	$195,804
														Subtotal = $195,804

Grand Total All Awards = $195,804

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Improving Guidance For Care Transitions For Clients Of Assertive Community Treatment (act) And Flexible Act

Award Number: K08MH142767

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2030

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