New SAMHSA Series of Evidence-Based Practice Toolkits

The Substance Abuse and Mental Health Services Administration has released the first update in its series of evidence-based practices toolkits. Assertive Community Treatment Knowledge Informing Transformation (ACT KIT) includes an array of materials designed to help agencies implement, sustain, and evaluate ACT programs and ensure that people with serious mental illness have access to these effective services.

The initial toolkit series began in 1998 when the Robert Wood Johnson Foundation convened a panel of researchers, clinicians, administrators, consumers, and family advocates to examine research evidence and determine which practices showed positive outcomes over multiple research studies. The panel identified six evidence-based practices: illness management and recovery, supported employment, family psychoeducation, assertive community treatment, integrated treatment for co-occurring disorders, and medication management. Between 2000 and 2005, toolkits for each of the practices were developed, pilot tested, and refined. A two-year national demonstration project to evaluate implementation of five of the practices in eight states was completed in 2008.

At the core of the newly released ACT KIT are three detailed volumes that cover implementation, training, and evaluation. The first volume, Building Your Program, is designed to help mental health authorities, agency administrators, and ACT leaders think through and develop the structure of ACT programs. The 70-page volume includes two sections of tips—one for mental health authorities and one for agency administrators and ACT leaders—that provide a wealth of practical advice. The final chapter, "Voices of Experience," presents transcriptions of interviews with three ACT program administrators, who provide the kind of down-to-earth guidance and support that could come only from day-to-day familiarity with the challenges of ACT services delivery.

The second core volume, Training Frontline Staff, is a workbook intended for use as both a training manual for group sessions and a basic desk reference. The 110-page workbook divides training into four modules: basic elements of ACT, recovery and the stress-vulnerability model, core processes of ACT, and the array of services that ACT programs provide, from medication support to health promotion to housing assistance and employment. Both volumes— Building Your Program and Training Frontline Staff —focus particularly on the differences between assertive and coercive treatment and how to ensure that consumers' rights are respected.

The 90-page manual, Evaluating Your Program, shows quality assurance team members how to assess the effectiveness of the ACT program and includes a readiness assessment, the ACT Fidelity Scale, the General Organizational Index, and outcome measures that are specific to ACT. Tips on how to use the data to improve the program are included.

The ACT KIT also contains materials designed to introduce the practice to a wide variety of stakeholders—mental health authorities, community members, employers, consumers, families and other supporters, and agency staff. Videos, brochures, and handouts in Spanish and English and a PowerPoint presentation are included, along with instructions for making the best use of these resources. Finally, a 32-page booklet, The Evidence, introduces all stakeholders to the research literature. It presents a review of the ACT literature, a selected bibliography for further reading, and references for the citations presented throughout the ACT KIT.

The ACT KIT can be downloaded from the Web site of the Center for Mental Health Services at mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits . A version that includes the CD-ROM and DVD can be ordered free of charge by calling 877-726-4727.