PMHP at UCLA
California Behavioral Health Services Act
ACT and FACT Center of Excellence
The Behavioral Health Services Act brings Assertive Community Treatment (ACT) and Forensic Assertive Community Treatment (FACT) to California.
For fifty years, ACT has helped people with severe mental illness thrive in the community. ACT brings care to people in their homes, in shelters, in group living settings, in locked settings, and on the street. ACT overcomes barriers to care to support recovery and community integration for those with the most significant behavioral health needs. We know that, when done well, ACT will improve client outcomes, reduce institutionalization and justice-involvement, reduce homelessness, and enhance client wellbeing.
Resources for behavioral health delivery systems and behavioral health practitioners
The Public Mental Health Partnership (PMHP) at UCLA will provide training to ACT and FACT providers in California to support implementation and fidelity.
PMHP’s training curriculum is built on four core approach pillars: Recovery-oriented Care, Trauma-informed Care, Harm Reduction, and Systems-oriented Care, and encompasses the ACT service delivery model and team approach, evidence-based practices, and relevant clinical competency areas. Training will be offered online via live training sessions and self-paced (asynchronous) courses.
Technical Assistance
Technical Assistance (TA) is one-on-one support offered to ACT teams to help deliver high-quality intensive behavioral health care. TA brings together tenets of the Continuous Quality Improvement (CQI) model, strategies for fidelity monitoring, and approaches for collaborative and data-driven decision-making to enable teams to describe and solve challenges, adopt best practices, and improve their services over time.
How It Works
TA Can Help With
ACT and FACT Data Tools
The Center of Excellence for ACT and FACT draws on partnered implementation approaches that help practitioners use data to develop skills in evidence-based practices, guide effective service delivery, and incentivize performance improvement. All data we collect will be shared back with teams in a timely, structured, and interactive way to help teams adopt data-informed care delivery approaches that improve their practice. Our training offerings will include topics such as the use of data to inform continuous quality improvement, the adoption of Measurement-Based Care, data-informed provider behavior change, and others. We will provide coaching and hands-on technical assistance to help providers use data to adopt effective care processes that positively impact members.
Fidelity Measurement. As explained in this video describing the Core Components Checklist, teams will pursue an incremental approach to achieving fidelity. Teams will complete a baseline fidelity assessment using the Core Components Checklist within 9 months of beginning ACT or FACT service delivery. In subsequent fidelity reviews, the ACT and FACT Center of Excellence will measure teams’ fidelity to the ACT model using the TMACT (Tool for Measurement of Assertive Community Treatment).
Member Outcome Measurement. ACT and FACT practitioners will submit member-level data to the ACT and FACT Center of Excellence as outlined below.
| ACT and FACT Member Outcomes | |||
|---|---|---|---|
| Domain | Measurement Tool Completed by Practitioner | Frequency | Estimated Time to Complete per Member |
| Quality of Life & Recovery | Illness Management and Recovery Scale (IMR) +Global Quality of Life Item (QOL-1; member self-report*) | Intake, every 6 months & at discharge | 5-8 minutes |
| Mood & Psychotic Symptoms | COMPASS-10 | Intake, every 6 months & at discharge | 10-12 minutes |
| Functioning & Service Engagement | Daily Living Activities Scale (DLA-20) +Service Engagement Scale (SES) | Intake, every 6 months & at discharge | 5-8 minutes |
| Member Status • Demographic Information • Housing • Justice & Legal Involvement • Productive Roles & Meaningful Activities | Items capturing member status | Intake, every 6 months & at discharge | 5 minutes |
*We recommend that members also complete the 15-item Questionnaire about the Process of Recovery (QPR) every 6 months to provide the team with person-centered, recovery-oriented information about member experience. |
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Further Reading
and Resources
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- Bauer, M. S., & Kirchner, J. (2020). Implementation science: What is it and why should I care? Psychiatry Research, 283, 112376.
- Brodwin, P. (2013). Everyday Ethics: Voices from the Front Line of Community Psychiatry. Univ of California Press.
- Coldwell, C. M., & Bender, W. S. (2007). The Effectiveness of Assertive Community Treatment for Homeless Populations with Severe Mental Illness: A Meta-Analysis. American Journal of Psychiatry, 164(3), 393–399.
- Cuddeback, G. S., Morrissey, J. P., Domino, M. E., Monroe-DeVita, M., Teague, G. B., & Moser, L. L. (2013). Fidelity to recovery-oriented ACT practices and consumer outcomes. Psychiatric Services, 64(4), 318-323.
- Dieterich, M., Irving, C.B., Bergman, H., Khokhar, M.A., Park, B., Marshall, M. Intensive case management for severe mental illness. Cochrane Database Syst Rev. 2017 Jan 6;1(1).
- Dixon, L. (2000). Assertive Community Treatment: Twenty-Five Years of Gold. Psychiatric Services, 51(6), 759–765.
- Estroff, S. E. (1999). A harmony in three parts: Utopian treatment for schizophrenia. New Directions for Mental Health Services, 1999(83), 13–19.
- Herinckx, H., Kerlinger, A., Cellarius, K. Statewide implementation of high-fidelity recovery-oriented ACT: A case study. Implement Res Pract. 2021 Feb 26;2.
- Leiphart, L. R., & Barnes, M. G. (2005). The Client Experience of Assertive Community Treatment: A Qualitative Study. Psychiatric Rehabilitation Journal, 28(4), 395–397.
- Manuel, J. I., Covell, N. H., Jackson, C. T., & Essock, S. M. (2011). Does Assertive Community Treatment Increase Medication Adherence for People with Co-occurring Psychotic and Substance Use Disorders? Journal of the American Psychiatric Nurses Association, 17(1), 51– 56.
- Rochefort, D. A. (2019). Innovation and Its Discontents: Pathways and Barriers in the Diffusion of Assertive Community Treatment. The Milbank Quarterly, 97(4), 1151–1199.
- Ruud, T., Selle, M. L., Clausen, H. K., Heiervang, K. S., Odden, S., Stuen, H. K., & Landheim, A. (2024). Clinical outcomes and outcome predictors of two-year assertive community treatment in Norway: an explorative prospective pre–post study. BMC psychiatry, 24(1), 1-13.
- Spivak, S., Mojtabai, R., Green, C., Firth, T., Slater, H., & Cullen, B. A. (2019). Distribution and Correlates of Assertive Community Treatment (ACT) and ACT-Like Programs: Results From the 2015 N-MHSS. Psychiatric Services, 70(4).
- Stanhope, V., & Matejkowski, J. (2010). Understanding the Role of Individual Consumer–Provider Relationships Within Assertive Community Treatment. Community Mental Health Journal, 46(4), 309–318.
- Thorning, H., & Dixon, L. (2020). Forty-five years later: The challenge of optimizing assertive community treatment. Current Opinion in Psychiatry, 33(4), 397.
- Tse, J., & Chablani, R. (2021). ACT for Life: Why Psychiatrists Pound the Pavement to Provide Care. Psychiatric Services, 72(9), 1099–1102.
Meet Our Leadership Team
Elizabeth Bromley, MD, PhD
Director
Lisa Davis, PhD, LCSW
Associate Director
Rosalinda Cárdenas, MPA
Administrative Director
Elizabeth Mackey, LMSW
Director of Training
Nancy Aréchiga, MBA
Associate Administrative Director
Joseph Mango, MFA
Media Director
Join Our Team
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