The Adolescent Community Treatment Service (ACTS) are a team of professionals that support young people and families in the community.
We work with young people aged between 13 and 18 years.
Young people might be referred to us because they require intensive support in the community during a period of crisis in their mental health.
There may be a variety of professionals involved in working with young people. It helps to know who they are and how they can help.
Psychiatrists
We are medically qualified doctors, who specialise in working with young people with mental health problems, and their families. If required, we can prescribe medication. The resident doctors in the team are in training to become child and adolescent psychiatrists.
Clinical Nurse Specialists
We are registered mental health nurses with substantial training and experience in supporting young people and their families with their mental health needs. We are experts in holistic care planning, assessment and delivering treatment. We also may be specially trained in delivering a specific therapy or prescribing and managing medication. As nurses, we manage complex physical health needs and support people who have difficulties with eating. We work with CAMHS inpatient hospitals and have an enhanced understanding of the experiences of young people as an inpatient.
Psychologists
We have different psychologists in the team, including assistants and trainee psychologists. We offer evidence-based psychological interventions. We help young people understand their thoughts and feelings and consider how these influences their actions. We can assess and support young people's psychological functioning, emotional wellbeing and development.
Systemic Family Therapists
We are psychotherapists (sometimes called family therapists or systemic psychotherapists) who work with young people, their families and their parents or carers. Family therapy focuses on relationships, context and communication to support with recovery. We focus on the whole system, rather than just the child.
Occupational Therapists
We work with young people and families to develop personalised strategies for enhancing coping skills, emotional regulation and daily functioning. We work with schools and families to create supportive environments for young people with mental health difficulties. We complete assessments to explore barriers and challenges that may impact participation in daily activities. We support young people to explore all aspects of daily life and tailor interventions that will enable young people to participate in daily meaningful activities that contributes to improved health and wellbeing.
Social Workers
We sometimes have registered social workers as part of the multidisciplinary team. A social worker’s role is to listen to and support individuals, families and communities, helping them find solutions to challenges and promoting their human rights and wellbeing. Social workers, like all our clinical staff, have a duty to protect people from harm. ACTS social workers provide mental health assessments, care coordination and specific interventions to the level of their training.
Administrators and Receptionists
We organise appointments, answer the phones, provide administrative support and welcome young people and their families into the service.
Pharmacists
We specialise in medication and work with young people, families and other healthcare professionals to ensure the safe and effective use of medicines. We are available to speak to you, should you have any questions about your medication.
- We aim to support young people experiencing severe mental health difficulties in a least restrictive environment.
- We provide assessment and treatment of young people in the community to prevent an inpatient admission.
- We support young people who have been discharged back into the community following an inpatient admission.
Care coordination
Each young person under our service will be allocated a care coordinator. Care coordinators provide support to young people and their families to help navigate challenges during periods of crisis. As care coordinators we complete regular assessments, manage risk and safety, monitor progress and develop collaborative care plans, while liaising with other professionals. Care coordinators also are responsible for discharge planning, ensuring a smooth transition to community-based services and developing an aftercare plan to maintain ongoing support for young people and families.
Risk management
This involves identifying, assessing and addressing potential risks with the aim of supporting safety. We develop a shared understanding of safety, co-produce safety plans with clear actionable steps and provide information about services and resources. We focus on emotional, social and physical wellbeing. We identify early warning signs of a crisis, teach coping strategies and identify support to help manage in a crisis. We also consider environmental safety, by supporting families to develop risk factors associated with the home environment. We collaborate with other agencies or professionals and help develop post-crisis support.
Goal setting
We establish specific, measurable, achievable, relevant and time-bound objectives that are aimed at improving a young person’s mental health and well-being. These goals serve as targets to work toward and guide the therapeutic process.
Social inclusion
We aim to break down barriers and promote equal opportunities for people with mental health challenges to engage in social, economic, educational and community activities without facing discrimination or stigma.
Medication review
Medication is used to treat some mental health conditions. A medication review is a chance for one of our team’s doctors to assess what medications a patient is taking, how they are working and whether they could be optimised, as well as to consider if other medications might help. It allows us to assess for any side effects and helps us to track progress during care under our team.
Medical review
A medical review involves a qualified medical professional assessing an individual's physical and mental health. Physical and mental health are interconnected. The review may include asking questions about an individual’s medical history, physical health, risk and examining the patient. Following the review, we will communicate with our patients and their families and with other healthcare providers, including the GP and hospital teams or other community services, if appropriate.
Psycho-education
We provide young people with information about mental health conditions and factors that may have contributed to their psychological challenges. This process supports young people to enhance their knowledge, awareness and insight into their difficulties and promotes self-management, coping skills and a sense of empowerment.
Psychological interventions
Cognitive behavioural therapy (CBT)
This is an evidence-based therapeutic modality that can support in the treatment of several mental health difficulties. It helps young people identify unhelpful patterns of thoughts and behaviours and assists in developing more helpful ways of thinking. It also helps young people think about different strategies to strengthen skilful behaviours.
Dialectical behavioural therapy (DBT)
This is an evidence-based therapy, widely used in treating those who struggle with intense emotions, interpersonal difficulties and suicidal and self-harming thoughts and actions. The overarching goal of DBT is to help people create a life worth living. DBT skills teach adolescents and families to regulate their emotions and behaviours, reduce problem behaviours, increase skilful behaviours and experience a range of emotions without necessarily acting on those emotions. It also helps improve relationships with family, school, and peers.
Trauma interventions
We offer a wide range of evidence-based trauma interventions to support young people process past traumatic experiences and reduce the distress caused by these experiences.
Systemic family therapy
This approach focuses on understanding and addressing issues within the context of family dynamics and relationships. Systemic family therapy aims to improve communication, enhance relationships, and promote healthier interactions among family members.
Occupational interventions
This involves the use of strategies to address daily routines and meaningful activities to support wellbeing and recovery during a crisis. We assess functioning, identify important activities, establish routines, teach coping skills and offer crisis-responsive techniques like mindfulness. Goals are set, adaptive strategies are taught, and social engagement is encouraged. The aim is to empower individuals to manage mental health challenges, promote recovery and stability through continued participation in valued activities.
School reintegration
We support young people to return to school after absences due to mental health challenges. We use a comprehensive and individualised approach to ensure that the transition back to the school environment is smooth and supportive, to enhance wellbeing and academic success.
Relapse prevention
We create plans and support strategies to minimise the recurrence or worsening of mental health symptoms and crisis situations. We collaboratively identify triggers, teach coping skills, and craft personalised relapse prevention crisis plans. By empowering young people to actively manage their mental health and address potential crises early, relapse prevention enhances stability and wellbeing over time.
If your parents/siblings or wider family have been affected by the ongoing difficulties, our service will be able to signpost to the appropriate service(s) who may be able to offer specialist support.
What happens during my first appointment?
During your first appointment you will meet with your care coordinator to complete outcome measures, discuss risk and safety planning and assess any physical health needs. Your care coordinator will support you to identify your individual treatment goals and discuss your care plan.
What are outcomes measures?
An outcome measure is a tool that is used before and after treatment, to monitor progress or effectiveness of an intervention. This will enable us to monitor changes in symptoms, behaviour or overall wellbeing, over time. These measures can include questionnaires, self-reports or feedback from parents, teachers or healthcare professionals. By using outcome measures, the care team can understand how well the treatment is working, make necessary adjustments and ensure that you are receiving the right support.
What can I do if I am unhappy about my treatment?
If you have any concerns about the care you are receiving, please ask to speak to one of our clinicians. A member of the team will sit down with you and listen to your concerns and offer support to try to resolve the problem. If necessary, you can escalate your concern to a more senior team member such as the Team Manager or Service Manager.
What can I do if I would like a second opinion?
A second opinion is when another doctor or expert looks at your care, diagnosis and treatment to make sure you are receiving the most appropriate support. If you're feeling unsure about your diagnosis, or would like to check that your care and treatment plan is the best for you, a second opinion can help. If you would like to request a second opinion you should speak to a member of staff in your ACTS care team, who can make a referral for a second opinion.
What are my rights under the Mental Health Act?
If you are under the care of ACTS, you will be supported intensively in the community and will not go into hospital.
ACTS will always aim to ensure that your choices are respected and reflected in decision-making and care planning. As a home treatment team, we offer a flexible approach to your care and offer least restrictive interventions. You have the right to be involved in decisions about your care and treatment, which may include medication and therapeutic options. We will work closely with you and involve your parents or carers, where appropriate, so that your voice is central.
If, while working with you, we no longer feel able to keep you safe in the community, an inpatient admission may be recommended. In these circumstances, if you decline an admission to hospital, we may request a Mental Health Act assessment. If detained under the Act, you have the following rights:
- To be told why you’re in hospital – staff must explain your section, how long it lasts, and your rights.
- To get an advocate – someone who helps you understand and speak up about your care.
- Involve your nearest relative – your nearest relative must be informed and can help you ask for discharge.
- Appeal your detention – you can ask hospital managers or a tribunal to let you leave.
- Safe, respectful treatment.
- Least restrictive interventions – supported by professionals using the least restrictive interventions as possible.
- Make decisions about treatment – whilst some aspects of care can be compelled under the Act, decisions about treatment should be discussed with you and your views considered.
- Complain if unhappy – you can raise concerns at any time.
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