Did you know that Quebec’s first Assertive Community Treatment (ACT) was created at the Douglas in September 1997? Since that time, more than twenty teams—inspired by the Douglas model—have emerged throughout the province.

Direct Involvement in Daily Life

This multidisciplinary team provides professional, personalized service and long-term intensive follow-up for Douglas clients in their daily living environment. The clients served suffer from severe mental illness and require support to regain functional autonomy. The team’s mission is to ensure these clients receive the services they require to remain in the community and enjoy the best possible quality of life.

“We are extremely proud of the work we’ve accomplished over the past 10 years. We’ve conducted over 100 000 interventions involving approximately 150 people during this period. It is a privilege to assist clients as they move towards recovery. By helping them integrate into community life, we aid them in taking their place in society. It’s better for people to recover in their own homes, rather than in the hospital.” explains Claude Descombes, ACT Team coordinator.

The Douglas ACT team is comprised of one psychiatrist and eleven client workers: four nurses, four human relations agents, two psychologists, and one rehabilitation assistant. Together with the Centre de crise l’Autre Maison, they offer services, 24/7.

We Work as One

The ACT Team functions in a unique way. “Every ACT client worker knows the dossiers of all of our clients, and we work as one. Clients get support when they need it—no matter the time of day, or if the primary client worker in charge of the dossier is busy elsewhere,” explains Terry Papafilis, human relations agent.

ACT Team members fulfill many roles. As well as providing community treatment, rehabilitation, and support services, they are involved in all aspects of their clients’ lives. This may involve providing conventional therapy, accompanying clients to medical appointments, or helping clients find jobs or stay on their medication regime. It may even involve defending client’s rights. It can also mean having coffee in restaurants with paranoid clients to help them socialize, or being at a client’s side during a meeting with a landlord or at the Caisse populaire. The ACT Team also provides support for the clients’ family members.

“To quote a wise Chinese proverb, ‘Give a man a fish and he eats for a day. Teach a man to fish and you feed him for a lifetime,’” explains Mary Makris, human relations agent. “Rather than doing things for clients, our goal is to help them learn skills that will enable them to act independently.”

“Flexibility and versatility are essential in this type of job. Our workdays are filled with unforeseen events. We need to use imagination and initiative, and be open to others. It’s well worth the effort, because it’s tremendously exciting to help people reach their life goals,” says Dominique Lord, nurse.

The effectiveness of the ACT model has already been well-established. A 2002 study, conducted by Douglas Institute Researcher Eric Latimer, PhD, and his team, showed the number of days of hospitalization and visits to Emergency fell drastically during the two years that clients in the study were followed by the ACT Team. The study also indicated that clients enjoyed a higher quality of life, plus more autonomy, fewer positive symptoms of mental illness, and lower rates of homelessness, drug addiction, and problems with the legal system. There were even increases in rates of regular employment.

And the Future…

In coming months, Douglas ACT Team goals include increasing their number of clients by 10 percent, consolidating their psychiatric legal services, including a peer helper in the team, and creating (together with community partners) a rehabilitation centre for clients dealing with a combination of severe mental illness and problems linked to drug abuse.

No doubt the next 10 years will mirror the team’s first decade—dynamic and devoted to promoting rehabilitation for people with mental illness.