ACT: A NEW OPTION IN MENTAL HEALTH TREATMENT

Jane Q., a 42-year-old married woman with two children, began experiencing panic attacks at work. With the attacks increasing in frequency and intensity, thus causing problems on the job, Jane was temporarily suspended from her job.

At that point, Jane began to socially withdraw from friends and family and to lose interest in normally pleasurable activities. She stopped going to church and to sports activities in which her children were involved.

Other stressors in Jane's life, such as the illness of her father and family financial problems, plus her depression, began to cause conflict with her husband. She began sleeping 16 hours each day, neglecting her family and duties at home.

After her mother advised Jane that she was in danger of losing her family, she sought help. She was enrolled in the Alternate Critical Treatment program at the Community Counseling Center, and after seven weeks on the program, her panic attacks decreased and old unresolved issues with her husband and family were resolved. She returned to work, church and ball games.

Jane could be any of a number of patients who have been helped by the ACT program, a partial hospital program designed to meet the mental health needs of individuals when they are in crisis.

One of the goals of the program is to attempt to prevent hospitalization. Managed care programs seek methods of limiting the cost of mental health care, and they actively pursue opportunities for shorter term hospitalization and transition to partial hospital programs.

David Cargle, program director of ACT, said, "We also work from the other end. When patients have been in the hospital and are discharged, they come into our program to help ensure that they work their way back into their homes and communities without further problems."

Length of stay in the program is generally four to eight weeks. The patients attend meetings for four hours a day on weekdays. In addition, services are provided in the homes to assist patients and their families with difficulties they might experience due to their illness. Some patients may have as much as 25 hours a week of direct therapy.

The staff of ACT is composed of a multidisciplinary treatment team. Members of the team include psychiatrists, registered nurses, master-degreed mental health professionals, bachelor-degreed mental health specialists and certified therapeutic activity therapists.

Participants in the program receive several services, including assessment and diagnosis, psychiatric medication coordination and monitoring, individual treatment planning by a multidisciplinary team, group and individual therapy, activities therapy, in-home therapy, and patient and family education and counseling.

Among the groups and activities are cognitive behavior therapy (relation of thoughts to emotions), relaxation training, stress management, nutrition education, activity therapy, and exercise groups.

There are no diagnostic restrictions to entering the program. Anyone experiencing acute symptoms of mental illness is eligible for the program. It must be established that the patient would be hospitalized if not for the ACT program. Therefore, physician referral is required.

Mati Stone, director of clinical services at Community Counseling Center, said what is unusual about the Community Counseling Center ACT program is that it is a partial hospital program with a home-based component, which enhances the ability of the program to meet the needs of the individual.

"Home visits are provided seven days a week on an as-needed basis as established in the patient's treatment plan," she explained. "Home visits provide the opportunity for professionals to understand the individual's functioning and family dynamics in a natural setting. Traditional partial hospital programs do not provide a home visit component."

Stone added that, based on literature she has read on partial hospital programs, Community Counseling Center has the only program across the nation that provides a home-based component. Traditional programs operate five days a week. The local program, by virtue of its home-based component, operates seven days a week.

The local ACT program, only about 6 months old, is filling a definite need in the community.

"We are encouraged by the positive feedback we receive from our patients, their family members, and in some cases, their employers regarding their outcomes," Cargle said. "It is great to know we're on the right track."

For Jane, it is now a blessing to see the dawn of a new day. She is much more in touch with her feelings and better equipped to communicate them to those who touch her life. She now copes with normal family conflict and life's ups and downs. For the first time in a long time, Jane is more hopeful about the future.