Direct and Indirect Time Inputs and Assertive Community Treatment

Carolyn S Dewa, Salinda Horgan, Dianne McIntyre, Gail Robinson, Terry Krupa, Shirley Eastabrook

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Assertive Community Treatment (ACT) is an appealing community program model because it proposes to provide individuals with coping skills that allow them to maintain independent lives in their communities and it offers the potential to decrease inpatient stays and increase community tenure. But, it is not without its limitations. Critics point out that ACT's unique elements also make it a potentially very resource intensive program - an important consideration in times of fiscal constraints. Though the charge may be justified, there is little in the literature that actually quantifies the intensity of resources used. The process through which it achieves outcomes is not frequently described. Using ACT team workload information, we examine the time trade-offs - direct for indirect time - involved with implementing this model. In addition, we describe the specific activities that make up the direct and indirect time inputs that go into supporting clients in the community through assertive team oriented case management.

Original languageEnglish (US)
Pages (from-to)17-32
Number of pages16
JournalCommunity Mental Health Journal
Issue number1
StatePublished - Feb 2003
Externally publishedYes


  • Assertive community treatment
  • Community mental health programs
  • Economic evaluation
  • Resource use

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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