Time in Assertive Community Treatment: A Statewide Quality Improvement Initiative to Reduce Length of Participation

The investigators describe a New York State initiative to increase flow through assertive community treatment (ACT) while encouraging transition to less intensive services. This initiative began as ACT approached full capacity and as evidence emerged that participants can sustain recovery post-ACT. Comparison of performance indicators over time showed that time in ACT decreased, turnover rate increased, and the percentage of ACT participants who met treatment objectives rose. Also, post-ACT rates of ambulatory behavioral health follow-up increased while rates of psychiatric inpatient hospitalization decreased. Monitoring utilization of services while demonstrating positive outcomes has become increasingly critical as states shift to managed health care.