Intensive ACT treatment renders impressive results

Members of the BC Crime Prevention Association heard last week how Vancouver Coastal Health and the Vancouver Police Department have collaborated to help many of the city’s most addicted and mentally ill clients lead less chaotic and more fulfilled lives.

“What we really wanted to bring to this crime prevention audience is the message that nobody is beyond hope,” said George Scotton, manager, Vancouver ACT.

Scotton along with Sgt. Howard Tran, the officer in charge of the VPD’s mental health unit and VCH ACT Team member presented their ACT findings last Thursday at the association’s annual training symposium.  “We wanted to impress upon this audience that with the right mix of support and programs even our most challenging and complex clients are able to reintegrate into society in a meaningful way,” Scotton said.

ACT – Assertive Community Treatment – began in 2011. Three ACT teams, with a total caseload of 191 clients, now work in Vancouver. Multi-disciplinary in approach, ACT Teams bring health care and life-skills support to clients; all of whom would have difficulty arranging and keeping appointments with traditional office-based health care practitioners.

ACT emphasizes recovery through community treatment and rehabilitation. To this end, ACT teams provide a customized array of services to keep clients out of the hospital and away from the criminal justice system.  On its law-enforcement side, the ACT team strives to reduce the number of contacts between police and their clients who are, primarily, the severely addicted and mentally ill.

And the program seems to be working. A recent sampling of 32 ACT Team clients shows that police contacts are down by 50 per cent over the past year. Both the VPD and VCH were initially hoping to see a 20 per cent reduction.

“ACT is really a story about innovation and partnership,” said Sgt. Howard Tran. “Collectively, our goal is to keep clients out of the hospital, reduce reliance on emergency services including police contacts and criminal justice involvement and help them to attain a life that is not driven by their illness.”

Who are ACT’s clients?

• Often have spent long time in the hospital or have frequent admissions
• Over-represented in homeless population—challenges to living independently
• Repeated police and criminal justice contact due to illness and addiction
• Reside primarily on the Downtown Eastside

Client snapshot

Sam* is a 30-year-old female who was homeless and banned from several shelters. A poly-substance user with a high-risk lifestyle, Sam also grappled with frequent periods of delusion, making her a regular user at VGH and SPH emergency departments. She was also considered one of the VPD’s Top Five referrals, given her frequent contacts with police.

Since her association with ACT, Sam’s contacts with police have dropped significantly. Her hospital visits and acute beds days are also down. She has been able to maintain her housing and is in a steady relationship. Most impressively, Sam is now employed by a major grocery store chain and has recently been selected for a supervisory role.

“Although not all stories are as successful as Sam’s, I can say with confidence that the vast majority of our clients do experience improved quality of life thanks to their association with one of our ACT teams,” said Scotton. “For exactly these reasons, the health care-law enforcement model we pioneered here in BC is attracting a lot of attention both nationally and internationally, from cities such as Portland, Calgary and the Queensland Police Service in Australia.”

Other stories about ACT

Vancouver ACT celebrates a year of success
VCH News – January 31, 2013

Vancouver police mental health team tries to stop the revolving door of arrest and treatment
Vancouver Sun – April 25, 2013