What’s Assisted Community Treatment (ACT)?

What’s Assisted Community Treatment (ACT)?

Assisted Community Treatment (ACT) allows a judge to require a mentally ill person who continues to refuse help to undergo outpatient mental health treatment. An ACT petition is made for chronically homeless individuals who are found to be dangerous to themselves or others and/or suffering from severe, untreated mental illness and incapable of making informed decisions about their own care and well-being.

ACT includes the appointment of a Guardian ad Litem (GAL) who is appointed by the Family Court to serve as an advocate for the individual determined to be lacking decisional capacity, case management, and treatment that may include long-acting antipsychotic injection. They require coordination with an attorney to file a petition to enact ACT law; treatment lasts 12 months, and extensions can be requested.

For more information regarding ACT, check out this piece by KHON2: Can courts order involuntary treatment for chronically homeless individuals?

Chronically Homeless

According to the US Department of Housing & Urban Development, someone who is chronically homeless is an unaccompanied homeless individual with a disabling condition who has been homeless continuously for a year or more or has experienced at least four episodes of homelessness in the past three years.

Episode of Homelessness: “Distinct, and sustained stay on the streets and/or in a homeless emergency shelter.”
Disabling condition: “Diagnosable substance abuse disorder, a serious mental illness, developmental disability, or chronic physical illness/disability.”

Milestones toward ACT Law

1999: Olmstead Act” – U.S. Supreme Court construed Title II of the Americans with Disabilities Act (ADA), requiring states to place qualified individuals with mental disabilities in community settings rather than in institutions whenever treatment professionals determine that such placement is appropriate.
2014: Assisted Community Treatment (ACT) law is launched in Hawaii.
2019: Amended ACT law for broader implementation to include patients who are not consistently taking medication and protocol clarification. The revision better defines “dangerous to self” as likely to become much more vulnerable or dangerous to others within 45 days, clarifies who assesses/suggests treatment programs and removes the requirement of past mental health-related hospitalization.
2021: Amended to have Guardian ad Litem appointed immediately upon acceptance of petition and removed the requirement of representation by a public defender.
2023: HB950 – Relating to Assisted Community Treatment Orders passes out of Conference. The measure empowers the attorney general to assist in filing ACT petitions, authorizes Family Court for online hearings, sets time parameters to make the processing of petitions and continuations more effective, and extends ACT orders from one year to two.

  • David F.
    Posted at 03:10h, 23 August Reply

    Good concise article with helpful history and references. Though an option to help get services to some, it remains that many in our community don’t meet criteria under the ACT law. Resources are scarce or don’t exist for families seeking help for a chronically mentally-ill loved one. And the gap between outpatient treatment and involuntary treatment results often times in criminalization, as treatment is mandated only after a serious crime is committed. As an advocate, I know well the length families will go, and difficulties they encounter, to help a loved one suffering with a mental illness. Mahalo for the hope you bring to many in our community! God bless

  • Cynthia R Hanson
    Posted at 18:37h, 16 August Reply

    Seeking assistance I need a social worker

    • Angie Knight
      Posted at 22:19h, 16 August Reply

      Aloha Cynthia, thank you for reaching out! I’ve forwarded your message to our outreach team, who will connect with you with some follow up questions to see if and how we can assist. If you’d like to provide more information or phone number to contact you, please email info@ihshawaii.org.

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