Hi everyone,
My name is François Neveu and i work for the center of excellence in the province of Quebec. Our goal is to promote best practices in all ACT and ICM teams of the province. We took time to study the ATR transition scale and here's our thoughts:
All the members took time to read the reports and study ATR items. We find that’s a tool who seem to work well with clinicians because the items are pretty easy to understand and the reports showed good results for the persons who have been discharged from ACT to other services with the cutoff score. The main questioning we had may be related to the way services are organise here in Quebec. We had three different offers to supports peoples in community. First, we have around 48 ACT teams. Those teams offers great support (more then 8 contacts monthly) and took care of meds and psychosocial rehabilitation. Second, we have nearly 110 intensive case management teams (ICM) who offers between 2 and 7 contacts a month, mostly to do psychosocial rehab. Finally, we had a third offers that we called light support. This kind of support is mostly offers by non-profit organisation and could take many forms. The pace is low, mainly 1 contact monthly and help to keep an eye on vulnerable peoples without support around them.
We find that the ATR is a good tool to guide clinician from ACT and ICM teams to discharge peoples from their services to light support. The cutoff score seems to work well and we’re confident that peoples won’t be coming back in a near future. But, we’re not so sure that the ATR is precise enough to help us to clearly make difference between people in ACT or ICM teams. For us, most of the ATR items are not specific enough to make a difference between one and the other service. When peoples reach the cutoff score, they don’t need ICM team because their functioning is to good for this kind of services.
So we started working on the Colorado scale made by Sherman and Ryan and made many changes to adapt the tool to our reality. We identify 12 areas of needs. The tool main goal is just to help clinical judgement right now because it don’t have scores and cutoff point, which would be a great addition in a near future. We plan to upgrade it in a near future and the ATR gives us good leads.
Be sure that we are open to discuss with everyone on how we can work to help better transition between ACT and ICM teams.
François neveu, Ph.D.
Clinician
Quebec center of excellence