TY - JOUR
T1 - Clinicians’ Perceptions of Challenges and Strategies of Transition from Assertive Community Treatment to Less Intensive Services
AU - Finnerty, Molly T.
AU - Manuel, Jennifer I.
AU - Tochterman, Ana Z.
AU - Stellato, Candice
AU - Fraser, Linda H.
AU - Reber, Cecily A.S.
AU - Reddy, Hima B.
AU - Miracle, Angela D.
N1 - Funding Information:
This work was supported by the Bristol-Myers Squibb Foundation and the New York State OMH. We would like to thank additional individuals at the Office of Mental Health including Suzanne Gurran, Gary Clark, Wanda Hines-McGriff, Sharon Kuriger, Robyn Meyer, and Debra Parker.
Funding Information:
Dr. Finnerty is the PI on the ACT Transitions grant funded by Bristol-Myers Squibb Foundation, however her time on this project was supported solely by the New York State Office of Mental Health. The grant funded the time of the following co-authors: Jennifer Manuel, Ana Z. Tochterman, Cecily Reber, Hima Reddy, and Angela Miracle. The remaining authors have no disclosures.
Publisher Copyright:
© 2014, The Author(s).
PY - 2014/1
Y1 - 2014/1
N2 - The study aimed to identify clinical strategies and challenges around transition from Assertive Community Treatment (ACT) to less intensive services. Six focus groups were conducted with ACT team leaders (n = 49). Themes were grouped under four intervention-focused domains: (1) client/clinical, (2) family and natural supports, (3) ACT staff and team, and (4) public mental health system. Barriers to transition included beliefs that clients and families would not want to terminate services (due to loss of relationships, fear of failure, preference for ACT model), clinical concerns that transition would not be successful (due to limited client skills, relapse without ACT support), systems challenges (clinic waiting lists, transportation barriers, eligibility restrictions, stigma against ACT clients), and staff ambivalence (loss of relationship with client, impact on caseload). Strategies to support transition included building skills for transition, engaging supports, celebrating success, enhanced coordination with new providers, and integrating and structuring transition in ACT routines.
AB - The study aimed to identify clinical strategies and challenges around transition from Assertive Community Treatment (ACT) to less intensive services. Six focus groups were conducted with ACT team leaders (n = 49). Themes were grouped under four intervention-focused domains: (1) client/clinical, (2) family and natural supports, (3) ACT staff and team, and (4) public mental health system. Barriers to transition included beliefs that clients and families would not want to terminate services (due to loss of relationships, fear of failure, preference for ACT model), clinical concerns that transition would not be successful (due to limited client skills, relapse without ACT support), systems challenges (clinic waiting lists, transportation barriers, eligibility restrictions, stigma against ACT clients), and staff ambivalence (loss of relationship with client, impact on caseload). Strategies to support transition included building skills for transition, engaging supports, celebrating success, enhanced coordination with new providers, and integrating and structuring transition in ACT routines.
KW - Assertive Community Treatment
KW - Barriers to discharge
KW - Facilitators of discharge
KW - Mental illness
KW - Transition
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UR - http://www.scopus.com/inward/citedby.url?scp=84893701430&partnerID=8YFLogxK
U2 - 10.1007/s10597-014-9706-y
DO - 10.1007/s10597-014-9706-y
M3 - Article
C2 - 24526472
AN - SCOPUS:84893701430
SN - 0010-3853
VL - 51
SP - 85
EP - 95
JO - Community Mental Health Journal
JF - Community Mental Health Journal
IS - 1
ER -