Continued from Criteria page for the Summit ACTT Program:
Functioning: Clients have significant functional impairments in one of the following three areas:
1. Activities of daily living: Inability to consistently perform daily living tasks required for community functioning. In this category, clients will have difficulty with 4 out of 7 of the following:
- Maintaining personal hygiene
- Meeting nutritional needs
- Maintaining interpersonal relationships
- Caring for personal business affairs
- Obtaining medical, legal or housing services
- Recognizing and avoiding common dangers to self or possessions
- Persistence or recurrent failure to perform daily living tasks except with significant support or assistance from others such as family, friends or relatives
2. Employment: Limited ability to remain employed at a self-sustaining level or carry out the homemaker role
3. Living situation: Limited ability to maintain a safe living situation
Service Use: Clients have problems that are indicators of high service-use needs including one or more of the following:
- High use of the acute care hospital system with 2 or more admissions in the past year or continuous hospitalization.
- Current residence in an inpatient bed or supervised community residence, but assessed as able to live more independently with the provision of intensive services.
- History of non-participation in office based targeted services for people with severe and persistent mental illness.
- High risk or recent involvement in criminal justice system, for example, arrest or incarceration resulting.
- Intractable (persistent or very recurrent) severe major illness symptoms.
- Homeless or at imminent risk of homelessness.
- Co-existing substance use disorder of significant duration.
The following criteria are to be used by an ACT Team in selecting clients “in the greatest need” of ACT services:
1. Clients with serious mental illnesses listed in the diagnostic nomenclature (currently the Diagnostic and Statistical Manual, Fourth Edition, or DSM IV, of the American Psychiatric Association) that seriously impair their functioning in community living. Priority is given to people with schizophrenia, other psychotic disorders (e.g., schizoaffective disorder), and bipolar disorder because these illnesses more often cause long-term psychiatric disability and because of ACT’s proven effectiveness with this population. Clients with other psychiatric illnesses are eligible depending on the level of the long-term disability. (Individuals with a primary diagnosis such as a substance abuse disorder, developmental disability and organic disorders are not the intended client group.)
2. Clients with significant functional impairments as demonstrated by at least one of the following conditions:
- Inability to consistently perform the range of activities of daily living required for basic adult functioning in the community (e.g., caring for personal business affairs; obtaining medical, legal, and housing services; recognizing and avoiding common dangers or hazards to self and possessions; meeting nutritional needs; maintaining personal hygiene) or persistent or recurrent difficulty performing daily living tasks except with significant support or assistance from others such as friends, family, or relatives.
- Inability to maintain consistent employment at a self-sustaining level or inability to consistently carry out the homemaker role (e.g., household meal preparation, washing clothes, budgeting, or child-care tasks and responsibilities).
- Inability to consistently maintain a safe living situation (e.g., repeated evictions or loss of housing).
3. Clients with one or more of the following problems, which are indicators of continuous high-service needs (i.e., greater than eight hours per month):
- High use of Schedule 1 hospital services or specialty hospital services, tertiary level services, or psychiatric emergency services such as mental health crisis response services.
- Intractable (i.e., persistent or very recurrent) severe major symptoms (e.g., affective, psychotic, suicidal).
- Coexisting substance abuse disorder of greater than 6 months.
- Involvement with the criminal justice system due to mental disorder, assessed at low to moderate risk in the community, and the ACT team has determined that it is able to manage the current level of risk in the community.
- Inability to consistently meet basic survival needs, residing in substandard housing, homeless, or at imminent risk of becoming homeless.
- Residing in an in-patient or supervised community residence, but clinically assessed as being able to live in a more independent living situation if intensive services are provided, or requiring a residential or institutional placement if more intensive services are not available.
- Difficulty effectively utilizing traditional office-based out-patient services.