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Assertive Community Treatment (ACT) teams at VCH

16/02/2022

Vancouver Coastal Health (VCH) has been at the forefront of delivering community-based and community-focused care to individuals who require a higher level and frequency of service, due to their vulnerable status, through the services provided by seven Assertive Community Treatment (ACT) teams.

ACT is an evidence-based service delivery model that combines treatment, rehabilitation and support services using team-based care as a community alternative to psychiatric hospitalization. These teams provide intensive, specific and continuous services to meet the needs of individuals living with serious and persistent mental health and/or substance use challenges, who have not benefited from traditional outpatient programs.

“The ACT teams support clients who may have otherwise fallen through regular pathways and present with different levels of comfort and need when it comes to traditional health settings," says Kiran Dhaliwal, Vancouver ACT manager. “Our ability to work from a place of flexibility, community-partnering and responsiveness helps match our services to where the client is at and support them in their transitions in community, inpatient and tertiary settings."

ACT uses a interdisciplinary team approach to deliver wrap around services. Staff represent a variety of disciplines including nursing, social work, occupational therapy, vocational rehab or recreational therapy, peer support and psychiatry. These roles are identified in the B.C. Provincial Standards for ACT, as is the importance in working with community agencies to provide holistic care. Team members work together with family/caregivers and the client as active partners to conduct a comprehensive assessment, develop a care plan for the client, and are jointly responsible for implementing and monitoring the plan.

Providing directed care to impacted communities

Though Vancouver has had teams that functioned similarly to ACT services based on outreach and engagement, the first high-fidelity team, ACT1, had its origins in 2009 and gradually evolved to align with the provincial standards. After initially receiving funding through a federal drug treatment funding program, VCH created two more ACT teams that were dedicated to delivering care to individuals with complex mental health, substance use, behavioural and social challenges living in Vancouver's Downtown Eastside.

In 2020, VCH received additional funding through the Ministry of Health (MOH) to operationalize a sixth ACT team in Vancouver and a new ACT Team Richmond. Both of the new teams have the capacity to provide services to clients with mental health challenges who are not engaging in traditional outpatient services despite high acuity/needs, are experiencing absolute or relative homelessness and/or are at high risk of overdose.

Amid the COVID-19 pandemic, the opioid epidemic and a housing crisis, the expansion of VCH ACT services has been instrumental in providing care to some of the most vulnerable people living in our community, being responsive not only to all the needs of clients, but to the evolving needs of their communities as well. The two new teams in Vancouver and Richmond work collaboratively with their local mobile response teams, community mental health teams, acute-care services, primary-care clinicians and local not-for-profit agencies.

Provincial advanced practice (AP)

To support the new VCH ACT teams and those across the province, the Ministry of Health announced annualized funding for a provincial advanced practice initiative. This is a newly created Regional VCH MHSU team, in partnership with the MOH. The ACT-AP is creating a provincial network of ACT clinicians and leaders though a communities of practice approach, and engaging various disciplines in developing and refining the tools that support services. ACT-AP has recently partnered with the Ontario Association for ACT and will be delivering a virtual learning program throughout 2022 to support continuing professional development across ACT staff in both provinces.   

“This new Ministry funding is creating the opportunity for B.C. to gain formal recognition not only as a national leader, but a global leader in ACT standards of best practice for highly vulnerable populations," says Dr. Daniel Vigo, Regional ACT – Advanced Practice Medical Lead with Mental Health and Substance Use at VCH.

Peer supporter uses his lived experience to help others

Recently, the Richmond ACT team hired peer supporter Mike Tibbles, who provides a unique perspective in understanding and serving clients with their mental health needs.

About 10 years ago, Mike was a patient in the inpatient Mental Health Unit at Richmond Hospital. At times, his mental health prevented him from enjoying life and doing the simplest tasks, but his care team stuck with him and supported him in taking small steps along his own journey to recovery.

Mike shares his experience in hopes that it will help other clients going through their mental health and substance use challenges.

“The perspective that I am able to bring to the team from my own journey means that patients and their families always have an advocate no matter how difficult their behaviour," says Mike. “With my experience going through the system, I have learned to be compassionate about how we interact and engage with clients, something I strive to bring to every interaction I have."

For more information on ACT teams and/or to participate in the development of a public facing website, please visit the Assertive Community Treatment website development engagement page. ​


SOURCE: Assertive Community Treatment (ACT) teams at VCH ( )
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