Evaluation of legislated assisted community treatment in the Northwest Territories

Wood, Megan (2020) Evaluation of legislated assisted community treatment in the Northwest Territories. Practicum Report. Memorial University of Newfoundland. (Unpublished)

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Abstract

Background: The Northwest Territories (NT) tabled the new Mental Health Act (‘the Act’) in 2018. Founded on the principles of person-centered and recovery focused care, the Act includes the use of Assisted Community Treatment (ACT). ACT is a treatment option for select individuals who have had an involuntary psychiatric hospitalization to continue mandated treatment in the community. However, there has been no uptake of ACTs in the NT to date. This evaluation project was designed to gain a greater understanding of the barriers to ACT implementation, and to identify strategies for enhancing their use. Methods: An integrative literature review was conducted to explore the evidence related to Community Treatment Orders (the more common term for ACT nationally). Consultations were organized to gain insight from representatives of the Government of the Northwest Territories (GNWT) on priority issues for evaluation. An evaluation plan was developed, and data were collected from health care provider groups to identify the issues related to the lack of ACT implementation. Results: Five themes were generated from the data: education and training barriers; concerns with ACT issuance; cultural considerations; ACT continuance concerns, and community resources and connections. Five main recommendations were then created to increase initial uptake of ACTs in the NT. Conclusions: Research on the effectiveness of CTOs is mixed but there are notable benefits for clients if they are enacted using a recovery-oriented framework. The GNWT’s efforts to support the implementation of ACTs will be optimized by using a collaborative and person-oriented approach with community and health system partners.

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