Treatment

Treatment is a systematic approach to relieving the primary symptoms and life results of mental illnesses. Treatment is intended to lessen and remove the symptoms of mental illnesses, prevent later reoccurrence or worsening of symptoms, and help individuals cope with symptoms when medications and other treatments are only partially successful. Treatment typically contains four elements:

  • Medications;
  • Individual therapy;
  • Crisis intervention; and when necessary
  • Psychiatric hospitalization.

Florida considers the following services as treatment options:

Florida Assertive Community Treatment (FACT)
Florida Assertive Community Treatment Team (FACT) services are available on a statewide basis and are modeled after the original Programs of Assertive Community Treatment (PACT) in Madison, Wisconsin. There are 31 FACT teams across the state. Each team is staffed with a program psychiatrist, peer specialist and a team leader with a total staffing of 12.3 Full Time Equivalents (FTEs). Each team has an independent advisory committee to assist the team develop resources in its community. FACT is unique in Florida - at present, it is the only service available that offers a housing, medication, and flexible funding subsidy to enrolled individuals. Each team is mandated to serve no more than 100 individuals. FACT guidelines have recently been revised so that enhancement funds can be used for an expanded variety of services and supports. FACT is not a self-directed program and participants do not receive fixed budget amounts for discretionary use. Clinical services are provided entirely within the FACT Team - that's what makes it unique. However, an expansion of acceptable uses for enhancement funds will provide participants greater opportunities for articulating and achieving their individualized recovery goals.

Assessment
These services assess, evaluate, and provide assistance to individuals and families to determine level of care, motivation, and the need for services and supports. Assessment also assists individuals and families in identifying their strengths.

Integrated Treatment for Individuals with Co-occurring Disorders
Florida understands that many adults in our priority populations have both a mental illness and substance use disorder. A good assessment and treatment for both at the same time is required so that people can get better. Making sure contracted providers in the public mental health and substance abuse systems can do a thorough assessment and provide or arrange for needed treatment is a current priority for the state.

Crisis Support / Emergency
These are outpatient services generally available twenty-four hours per day, seven days per week, or some other specific time period, to intervene in a crisis or provide emergency care.

Crisis Stabilization Unit (CSU)
This is an emergency care intervention, available twenty-four hours per day, seven days per week. People can go to a CSU, or be brought there by police, friends or relatives. They are assessed and may be admitted voluntarily or against their wishes until the mental health emergency is over.

Health Services (see also Medical Services, which follows later in this section)
Florida's publicly-funded community mental health system does not directly purchase other types of health services. However, as part of the assessment process, case managers pursue needed health care (e.g., medical services other than psychiatric; dental care; eye care / glasses) by using resources available in the community. These efforts could include referrals to local physicians who accept Medicaid, county public health units, or physicians who provide free service time. The issues are varied and can range from routine vaccinations to treatment for diabetes or other life-threatening illnesses.

In-Home And On-Site Services
These are therapeutic services and supports rendered in non-mental health provider settings, such as in nursing homes, assisted living facilities (ALFs), residences, schools, detention centers, commitment settings, foster homes, and other community settings.

Inpatient Services
These are services provided in hospitals licensed under Chapter 395, F.S., as general hospitals and psychiatric specialty hospitals. They are designed to provide intensive treatment to persons exhibiting violent behaviors, suicidal behaviors and other severe disturbances due to substance abuse or mental illness.

Intervention - Individual or Group
These services focus on reducing risk factors generally associated with the progression of substance abuse and mental health problems. Intervention is accomplished through early identification of persons at risk, performing basic individual assessments, and providing supportive services that emphasize short-term counseling and referral. These services are targeted toward individuals and families.

Medical and Dental Services
Medical services provide primary medical care, therapy, and medication administration. This includes a psychiatric mental status assessment, and the administration of psychiatric medications. For adults, medical services are usually provided on a regular schedule with arrangements for non-scheduled visits during times of increased stress or crisis.

Case managers also do an assessment of the need for medical and dental services (see also Health Services in this section, above), and referrals are made to physicians or dentists in the community who accept Medicaid. People who do not have Medicaid are referred to whatever medical or dental services are available locally. These resources may include Regional Workforce Board One-Stop Centers and public health departments, medical societies, individual physicians, and hospitals. The Department pays for medical and dental care for individuals living in state mental health residential treatment facilities.

Outpatient-Individual and Group
This cost center provides a therapeutic environment that is designed to improve the functioning or prevent further deterioration of persons with mental health and/or substance abuse problems. Outpatient services are usually provided on a regularly scheduled basis by appointment, with arrangements made for non-scheduled visits during times of increased stress or crisis.

Residential Level 1
These are licensed services that provide structured, live-in, non-hospital settings with 24-hour supervision daily. There is a nurse on duty in these facilities at all times. For adult mental health, these services include two different kinds of programs: group homes and short-term residential treatment services. Group homes are for residents who may require longer lengths of stay. These facilities offer nursing supervision provided by, at a minimum, licensed practical nurses, 24 hours a day, seven days per week.

Residential Level 2
These are licensed, structured rehabilitation-oriented group facilities that have 24-hour a day, seven days per week supervision. Level 2 facilities are for persons who have significant deficits in independent living skills and need extensive support and supervision.

Short-term Residential Treatment (SRT)
These individualized, acute, and immediately sub-acute care services provide intensive mental health residential and rehabilitative services 24 hours a day, seven days per week. These services must meet the needs of individuals who are experiencing an acute or immediately sub-acute crisis and who, in the absence of a suitable alternative, would require hospitalization. SRT services provide intensive residential treatment for individuals in need of acute care for up to 120 days.