Adult Mental Health (AMH)
The System of Services and Support
The Florida Department of Children and Families’ Office of Substance Abuse and Mental Health (SAMH) serves as the single state agency for the provision of mental health and substance abuse services. SAMH contracts with seven Managing Entities statewide to manage the delivery of behavioral health services through a network of local service providers. SAMH promotes a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resiliencies of individuals, families and community to improve the health, wellness, and quality of life for those with behavioral health conditions.
The process of treatment and recovery is highly personal and occurs via many pathways. It may include assessment and clinical treatment, therapy, medications, crisis intervention, psychiatric hospitalization, peer and family supports, among other approaches. Recovery support services include culturally and linguistically appropriate services that assist individuals and families working toward recovery from mental health conditions.
Florida’s recovery-oriented system of care offers the following treatment service options for adults with mental health disorders:
Florida Assertive Community Treatment (FACT)
In an effort to promote independent, integrated living for individuals with severe and persistent psychiatric disorders, Florida Assertive Community Treatment (FACT) teams provide a 24-hour-a-day, seven-days-a week, multidisciplinary approach to deliver comprehensive care to people where they live, work or go to school, and spend their leisure time. The programmatic goals are to prevent recurrent hospitalization and incarceration and improve community involvement and overall quality of life for program participants. FACT teams assume responsibility for directly providing the majority of treatment, rehabilitation and support services to individuals. Emphasis is on recovery, choice, outreach, relationship-building, and individualization of services. Enhancement funds are available to assist with housing costs, medication costs, and other needs identified in the recovery planning process. The number of contacts and the frequency at which they are provided is set through collaboration rather than service limits. Statewide, there are 33 FACT teams staffed with a psychiatrist, licensed mental health professionals, nurses, a vocational specialist, a substance abuse specialist, peer specialists and case managers. Each team serves 100 individuals with an average caseload of 1:12.
Assessment includes the systematic collection and integrated review of individual-specific data, such as examinations and evaluations. This data is gathered, analyzed, monitored and documented to develop the person’s individualized plan of treatment and to monitor recovery. Assessment specifically includes efforts to identify the person’s key medical and psychological needs, competency to consent to treatment, history of mental illness or substance use and indicators of co-occurring conditions, as well as clinically significant neurological deficits, traumatic brain injury, organicity, physical disability, developmental disability, need for assistive devices, and physical or sexual abuse or trauma.
Crisis Support / Emergency
This non-residential care is 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. Examples include: mobile crisis, crisis support, crisis/emergency screening, crisis telephone, and emergency walk-in.
This acute care service, offered twenty-four hours per day, seven days per week, provides brief, intensive mental health residential treatment services. This service meets the needs of individuals who are experiencing an acute crisis and who, in the absence of a suitable alternative, would require hospitalization.
In-Home And On-Site Services
These are therapeutic services and supports rendered in non-mental health provider settings, such as nursing homes, assisted living facilities (ALFs), residences, schools, detention centers, commitment settings, foster homes, and other community settings.
These services are provided in psychiatric units within 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 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 services provide primary medical care, therapy, and medication administration. Medical services are designed to improve the functioning or prevent further deterioration of persons with mental health or substance abuse problems, including psychiatric mental status assessment. For adults with mental illness, medical services are usually provided on a regular schedule with arrangements for non-scheduled visits during times of increased stress or crisis.
Outpatient Services provide 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 I
These licensed services provide structured, live-in, non-hospital settings with 24-hour supervision, seven days per week. 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.
Residential Level II
These are licensed, structured rehabilitation-oriented group facilities that have 24-hour a day, seven days per week supervision. Level II facilities house 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 short and 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.