Assertive community treatment (ACT) is an evidence-based model of treatment for individuals with severe and persistent mental illness for whom traditional approaches have been ineffective. Individuals appropriate for Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) are those that have had frequent or prolonged hospitalizations, or experienced homelessness or incarceration by virtue of their mental illness.

Individuals in assertive community treatment programs have a primary diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or chronic major depression. Many of these individuals also have substantial problems with substance use.

Assertive community treatment programs are typically staffed by a multidisciplinary team of physicians, nurses, social workers, substance abuse counselors, occupational therapists, and rehabilitation therapists. The team provides consistent care and assertive client advocacy by teaching individuals in the program ways to improve quality of life, self and home care, and resource utilization. For example, team members may assist individuals in the program with:

  • Accessing and maintaining benefits
    • Food stamps
    • Medicaid
    • Social Security
  • Gaining and maintaining employment
  • Housing
  • Maintaining activities of daily living
    • Bathing, grooming, cooking, housekeeping
    • Paying bills
    • Taking medications
    • Transportation
  • Managing medications and symptoms

At the University of Iowa, members of the IMPACT team visit individuals in the program at their homes or in their communities three to four times a week. In some cases, team members visit individuals on a daily basis. A member of the IMPACT team is on-call 24/7 and makes weekend visits as needed. Team members also meet Monday through Friday to review the needs of each individual in the program and plan a schedule for the day.

The goal of the program is to assist individuals with serious mental illness meet their goals of independent living and reduce their need for hospitalization.

Care Team

Physician, Psychiatry


  • Leah Appell, Team Leader BSN, RN-BC
  • Janet Crigger
  • Belinda Dewitt
  • John Grace
  • Tim Logan
  • Colleen Peterson Grace
  • Belinda Siglin
  • Susan Todd