The Queensland Homeless Health Outreach Teams: Do they use the Assertive Community Treatment (ACT) model?

Abstract

As a response to homelessness and its relationship with mental health problems, Queensland established homeless health outreach teams. These teams were designed to provide assertive outreach to homeless people by specialist mental health practitioners. The aim of this research was to determine to what extent these teams operate within an established framework for effective assertive outreach. A secondary aim was to determine the validity of an existing fidelity measure in evaluation of homeless outreach services. The Dartmouth Assertive Community Treatment Scale (DACTS) was administered to the five Queensland Homeless Health Outreach Teams (HHOT). It was found that the teams operated in the middle range on the fidelity measure with higher fidelity in human services and services than in organizational boundaries. Overall, the larger, more metropolitan teams appeared to achieve higher fidelity than the smaller more rural teams. Low fidelity scores can, in part, be attributed to weak validity of some DACTS items in relation to homeless outreach services as provided by Queensland HHOT services and recommendations are made for revision of the instrument to make it more suitable for use with these teams.