Assertive Community Treatment

Daniel / August 26, 2016 / Blog Psychiatric Nursing / 0 comments

What does practicum look like? It’s as unique as the classmates that are sharing the experience with me.

For me, it’s the Psychiatric Assessment Unit at Vancouver General Hospital. For another classmate, it’s psychogeriatric care at a private facility, for another it’s acute inpatient care at St. Paul’s. Each of us had the opportunity to rate settings we would like to be in for our final practicum, with the goal of being exposed to the type of work we want to be in once we graduate.

For some, this may lead to the realization that the particular setting they were selected for isn’t actually the best for them.

I can consider myself lucky, with my preceptor on holidays the first week of August, I got the opportunity to hit the streets and do some outreach with one of the Assertive Community Treatment (ACT) teams for Vancouver Coastal Health. Vancouver Coast Health’s 4 ACT teams are a model of success that many North American jurisdictions are watching and mimicking in their own areas. The teams have a unique partnership with the Vancouver Police Department’s mental health liaison team, and together they are making a measurable impact throughout Vancouver, in particular on the Downtown Eastside (DTES).

ACT clients are typically in the DTES, and cross many cultural boundaries and socioeconomic backgrounds.

ACT clients are typically in the DTES, and cross many cultural boundaries and socioeconomic backgrounds.

The ACT teams are a unique group of mental health care providers, having a shared team caseload, these nurses, occupational therapists, peer support workers, social workers, and psychiatrists fan out on a daily basis and ensure care needs and goals of clients are met. Just from hospital admissions, ACT clients have seen a 70% reduction in hospitalizations resulting in significant efficiencies for taxpayers and clients’ level of care.

The shifts I had with ACT really were an eye-opener for me. Before my first day, I had never stepped foot inside a single-room occupancy hotel, or SRO. You hear many stories, but until you see one it is an abstract concept. The conditions I encountered were just as bad or worst then some I had seen on the streets of Vietnam. Providing depot injections in an SRO was also a surreal experience, contrasting vastly to the largely sanitary conditions of the hospital, you do what you can to promote the best possible outcomes for clients. Furthermore, ACT is more than just mental health care. It provides a holistic approach to care that I had yet to experience. Meeting with a client and taking them out for coffee and just having a normal conversation, or going for lunch with another and trying to help obtain identification for them. For others, it can just be a welfare check to make sure they are still doing ok, as clients can be at various levels of care and stages of their recovery process. The experience I have garnered here will be on my mind throughout my career I’m sure.

As I prepare for entry-level practice in mental health, this experience really opened my eyes to a much larger picture of both the clients that will come under my care, and the continuum that is required to ensure positive outcomes.

The sociological impacts and the need to enhance my holistic approach will not be lost on me as I encounter new clients in the hospital; as I attempt to understand the situations they come from in order to determine how we can best support them. As a soon-to-be entry-level nurse, I think it is important to remember the human condition that has brought clients our way, and that there is more to each client that what we see on the surface and read on paper.

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