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Assertive Community Treatment: A Paradigm Shift in Treating Severe Mental Illness

  • 11/17/2023
  • 11:00 AM - 2:00 PM
  • Children's Services Council 2300 High Ridge Road Boynton Beach, FL 33426


Assertive Community Treatment: A Paradigm Shift in Treating Severe Mental Illness

John Puls, LCSW

It is estimated that nearly 6.3% of the population nationally is suffering from severe mental illness (SMI), which equates to approximately 14.8 million people in the United States (NIHM). Severe mental illness is simply defined as someone with a moderate to severe psychiatric disorder, with significantly impaired social and occupational functioning, that requires long term care. SMI is often associated with individuals suffering from a psychotic disorder such as schizophrenia, schizoaffective disorder, schizophreniform, delusional disorder, and substance induced psychotic disorder. Bipolar disorder, other mood disorders, and personality disorders can also be considered severe mental illnesses depending on the severity and the care required.  

The vast majority of those suffering from SMI will never receive proper treatment due to the lack of available resources. As a result, many people living with SMI will end up incarcerated and have repeated involvement in the criminal justice system. This issue was exacerbated by the deinstitutionalization movement in the 1970's that sought to close down "asylums" and other long term psychiatric facilities with the intention of integrating people into the community. Regrettably, this community integration plan fell significantly short of the desired outcome. 

 Developed in the early 1970s, assertive community treatment (ACT) was developed to be the gold standard for working in the community with individuals with severe mental illness. ACT challenges the conventional model of patients going to inpatient facilities for an acute stabilization period and then being expected to attend outpatient care on their own. Alternatively, ACT seeks to bring treatment to patients in the community. Services include wrap around case management services, counseling, and medication management with psychiatric care. 

 Learning objectives:

1 - Comprehend the history of treatment of clients with severe mental illness in the United States

2 - A through understanding of the scope and frequency of severe mental illness 

3 - Understanding the deinstitutionalization movement and the related consequences 

4 - Develop an initial understanding of the assertive community treatment model and the benefits of using ACT with severe mental illness 

5 - Understand the available resources for client's with severe mental illness 

 2.0 General CEU Hours

John Puls, LCSW began working with individuals suffering from substance use disorder and acute mental illness in 2013 in a support staff role. During this time, John completed his bachelor’s degree in social work from Florida Atlantic University while working as a case manager. John was accepted to the advanced standing master’s in a social work program at Florida Atlantic University and is currently a licensed clinical social worker. While working as a primary therapist in a residential substance use disorder facility, John became a master's level certified addiction professional (MCAP) through the Florida Certification Board. John is passionate about educating social work students and serves as an adjunct professor at the School of Social Work at Florida Atlantic University. Additionally, John works closely with legal professionals as a forensic social worker, providing case reviews and expert testimony involving addiction and addiction treatment facilities. John owns a private psychotherapy, crisis intervention, and case management practice in Boca Raton, FL.

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