As­sertive com­mu­nity treat­ment helps with se­vere men­tal ill­ness

Many men­tal con­di­tions do not re­quire long-term hos­pi­tal­iza­tion to ren­der ef­fec­tive treat­ment.

The Standard Journal - - LOCAL LIVE WELL POLK - By Me­lanie Dal­las Guest Colum­nist

As a li­censed pro­fes­sional coun­selor that has worked in the men­tal health field for more than 30 years, I can tell you that ‘men­tal ill­ness’ is not a sin­gle con­di­tion.

There are a va­ri­ety of men­tal ill­nesses that can cause a range of symp­toms. In some cases, men­tal ill­ness may be tem­po­rary — for ex­am­ple, grief-re­lated de­pres­sion — and does not re­quire com­plex or long-term treat­ments in or­der to re­cover.

How­ever, other types of men­tal ill­ness — such a se­vere bipo­lar dis­or­der or schizophre­nia - can be highly-com­plex chronic con­di­tions that can af­fect in­di­vid­u­als through­out their lives and re­quire equally com­plex treat­ments. In some cases, these ill­nesses can cause cog­ni­tive and func­tional im­pair­ments.

As re­cently as a gen­er­a­tion ago — and for hun­dreds of years be­fore — in­di­vid­u­als with se­vere and per­sis­tent men­tal ill­ness (SPMI) were com­mit­ted, con­fined or other­wise in­sti­tu­tion­al­ized in state men­tal hos­pi­tals or asy­lums. But through­out the 20th cen­tury, as our un­der­stand­ing of men­tal ill­ness and es­pe­cially med­i­ca­tion, ther­apy and other treat­ments in­creased, it be­came ap­par­ent that in­di­vid­u­als with SPMI were ca­pa­ble of liv­ing out­side in­sti­tu­tions.

To­day, the vast ma­jor­ity of in­di­vid­u­als with SPMI live in their com­mu­nity rather than a hospi­tal. In Ge­or­gia, when the state closed its psy­chi­atric hos­pi­tals — in­clud­ing North­west Ge­or­gia Re­gional Hospi­tal in Rome — ser­vices for in­di­vid­u­als with SPMI be­came the re­spon­si­bil­ity of Ge­or­gia’s 26 com­mu­nity ser­vices boards, state-des­ig­nated men­tal health agen­cies such as High­land Rivers Health.

I don’t usu­ally spend many words toot­ing our own horn, but I feel it is im­por­tant that mem­bers of the com­mu­ni­ties we serve un­der­stand some of the more com­plex work we do — work that might seem to go on be­hind the scenes, and cer­tainly out­side our more vis­i­ble out­pa­tient clin­ics. To­ward that end, one pro­gram I’d like to high­light is called as­sertive com­mu­nity treat­ment, or ACT.

ACT is an in­ten­sive com­mu­nity-based pro­gram — mean­ing it pro­vides a vari- ety of ser­vices in­di­vid­u­al­ized to a per­son’s spe­cific needs, and those ser­vices are de­liv­ered in the com­mu­nity (i.e., usu­ally in the per­son’s home). ACT is one of the old­est and most widely re­searched ev­i­dence-based treat­ment prac­tices and is tar­geted specif­i­cally to in­di­vid­u­als with SPMI who are most at-risk of psy­chi­atric cri­sis, hos­pi­tal­iza­tion and/or in­volve­ment in the crim­i­nal jus­tice sys­tem.

ACT ser­vices are pro­vided by a mul­ti­dis­ci­plinary team of men­tal health pro­fes­sion­als. For ex­am­ple, High­land Rivers’ ACT team in­cludes a psy­chi­a­trist, a li­censed clin­i­cian/ther­a­pist, a sub­stance abuse coun­selor, a cer­ti­fied peer spe­cial­ist and a para­pro­fes­sional. All team mem­bers pro­vide ser­vices to each in­di­vid­ual, and a mem­ber of the team is avail­able any time day or night (week­ends and hol­i­days too).

De­pend­ing on the spe­cific needs of the per­son re­ceiv­ing ACT ser­vices, a team mem­ber may visit him or her at home ev­ery day. The ACT team helps in­di­vid­u­als with SPMI learn to man­age med­i­ca­tion and symp­toms, to man­age house­hold items and hy­giene (if nec­es­sary), to find other re­sources (for ex­am­ple, for food, util­i­ties, hous­ing) and much more. The ACT team can also help an in­di­vid­ual find ap­pro­pri­ate em­ploy­ment if he or she wants and is able to work, or to se­cure dis­abil­ity in­surance if not.

In short, as­sertive com­mu­nity treat­ment helps in­di­vid­u­als with se­vere chronic men­tal ill­ness live as in­de­pen­dently as pos­si­ble in their com­mu­nity — the def­i­ni­tion of liv­ing in re­cov­ery. ACT ser­vices also help re­duce the risk of in­di­vid­u­als with SPMI ex­pe­ri­enc­ing psy­chi­atric cri­sis and end­ing up in the hospi­tal, jail or other in­sti­tu­tion. It is in­tense, com­plex work — and it goes on ev­ery day in the com­mu­ni­ties served by High­land Rivers and the state’s other CSBs.

For more in­for­ma­tion about ACT and other in­ten­sive com­mu­nity-based ser­vices, visit http://high­landriver­ / men­tal-health-ser­vices.

Me­lanie Dal­las is a li­censed pro­fes­sional coun­selor and CEO of High­land Rivers Health, which pro­vides treat­ment and re­cov­ery ser­vices for in­di­vid­u­als with men­tal ill­ness, sub­stance use dis­or­ders, and in­tel­lec­tual and de­vel­op­men­tal dis­abil­i­ties in a 12-county re­gion of north­west Ge­or­gia that in­cludes Bar­tow, Chero­kee, Floyd, Fan­nin, Gilmer, Gor­don, Har­al­son, Mur­ray, Pauld­ing, Pick­ens, Polk and Whit­field coun­ties.

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