Prakash & Ellenhorn is an Assertive Community Treatment (ACT) program, providing integrated, multidisciplinary care to individuals suffering severe and persistent mental illnesses. The majority of our services are provided to our clients in their homes and communities. Working flexibly and intensely with individuals in their own environs, we are an effective alternative to residential care and hospital care.


Assertive Community Treatment is the most widely tested model of psychiatric community care for persons with severe and persistent mental illness [references]. It is endorsed by both the National Alliance for the Mentally Ill and the National Institute of Mental Health as a highly effective evidence-based treatment, and as a "best practice" in community mental health. Research on ACT programs evidence that they are effective in decreasing hospital rates, improving employment outcomes, stabilizing and reducing psychiatric symptoms, and increasing sobriety.

ACT is a "single source" model of treatment. This makes it unique among other community-based services. Instead of providing only one component of a person's treatment and referring-out for other services, ACT programs offer a full range of rehabilitation and treatment resourced delivered by a multidisciplinary team. In this integrated approach to services, the "whole person", rather than a cluster of symptoms, is treated as the site and source of rehabilitative and recovery concerns. Focusing on the "whole person" ACT programs provide flexible, individualized and comprehensive services, often conducted in the comfort of their clients' homes and communities. Over 75% of the services provided by ACT programs occur outside the office, providing a highly adaptable support to clients in diverse community and vocational situations. Working flexibly and intensely with individuals in their own environs, we are an effective alternative to residential or hospital care.

A client utilizing the Prakash & Ellenhorn ACT program is served by a team of experts, who meet daily to coordinate care. At the onset of treatment, this team conducts an intensive thirty-day assessment of the client. The assessment evaluates the client's status in diverse areas such as personal and social development, vocational and educational pursuits, skills in daily activities, psychiatric condition, and physical health. Using the assessment as a guide, the team then develops a treatment plan. In consultation with the client, they make modifications in the plan if needed. The team follows the plan as they move forward with the client, providing the majority of the care needed in the client's recovery process, making minimal referrals to other providers


Almost fifty years since the first efforts to shift psychiatric treatment from the hospital to the community, care in the community remains confusing and inflexible - at times a hodgepodge of treatments and interventions lacking thoughtful direction. In large part, this chaotic provision of care is caused by a considerable gap between outpatient treatment and supervised institutional settings such as psychiatric hospitals and half-way houses.

Persons suffering a severe mental illness face a confusing marketplace of services that is often starkly divided by the intensity of care offered:

At one extreme, psychiatric patients seek 24-hour arrangements in psychiatric hospitals or half-way houses, where they are removed from the general population. This treatment is often overbearing, making them more dependent on others that they need to be. [example]

At the other extreme, psychiatric patients only receive outpatient treatment in office-based settings, but lack minimal support when they return back to their own communities where they generally have to fend for themselves.

Nowhere is this gap in intensity more prevalent than in instances when a person is experiencing acute psychiatric symptoms. When, for example, a patient who receives treatment from a psychiatrist in the community is plagued by increasingly unbearable symptoms, her only recourse is to contact the psychiatrist, arrange an adjustment in medication or perhaps schedule an extra session. If these choices do not take care of the problem, the patient's next option is exceedingly more intense than her first: hospitalization. If she is hospitalized, she and the hospital staff are met with another system of extremes when she approaches discharge. Currently, responsibility for discharge planning rests almost wholly on the shoulders of inpatient hospital staff. Thus, with little support from outpatient services, unit staffs must assure prior to discharge that their patients are either referred to more intensive, outpatient care, or have attained a safe baseline of symptoms such that they can return independently to the community. In the present managed care environment, either of these options is sought by staff under the pressure of often arbitrary time constraints. Thus, if the patient in our example is hospitalized, she faces at least two real, yet unsatisfactory, discharge possibilities: that she will be discharged too early, returning to the community with little support, or that she will be discharged too late, while she awaits either the link to more intensive outpatient services or the attainment of a full recovery to her previously held level of functioning. The Prakash & Ellenhorn Assertive Community Treatment program bridges the gap between these two extremes, properly addressing the problems and shortfalls associated with the treatment options available at the extremes listed above, by providing an appropriate intensity of client-centered psychiatric care. ACT programs, which involve multidisciplinary teams offering outreach services to clients in the community 24-hours a day, are like "hospitals without walls", responding to their clients' needs with a flexible team approach.