Team work in action: Building grounds for psychiatric medication decisions in assertive community treatment

Interdisciplinary teams are a common organisational form in community mental health treatment (see also Pino, Chapter 34, this volume), particularly for adults with serious and persistent mental illness. Assertive community treatment (ACT) is the most widely known team model (Simmonds, Coid, Joseph, Marriott, & Tyrer, 2001). The ACT model was originally designed to mimic the multidisciplinary functions of an inpatient unit in a community-based setting, with the aim of preventing long-term institutionalisation (Stein & Test, 1980). ACT teams offer round-the-clock comprehensive case management and psychiatric medication support and tend to be reserved for individuals with extensive histories of hospitalisation and treatment non-adherence. Other, less intensive models of case management using a multidisciplinary team approach have also been developed and are widely used in the United States and the United Kingdom.