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The System of Services and Support

The kinds and amounts of publicly funded mental health services available in an area are limited by the amount of funding available in that area. The following list shows the kinds of services that can be provided to people who meet the adult mental health priority population criteria.

Florida's service array can be put into the three broad categories: treatment, rehabilitation, and support services. However, many of the services identified in any one of the three categories could also be identified in one or more of the others. Assertive Community Treatment and Comprehensive Community Service Teams are two examples of services falling into more than one broad category.


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.

Crisis Stabilization

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.

Inpatient Services

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

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

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.


Rehabilitation is the process of helping individuals minimize the effects of mental illnesses on major role skills and develop greater competencies in employment, activities of daily living, social performance. They promote recovery.

Florida considers the following services as rehabilitation options:

Aftercare services
These services include but are not limited to relapse prevention, and are a vital part of recovery in every service level. Aftercare activities include customer participation in daily activity functions that were adversely affected by mental illness and/or substance abuse impairments. New directional goals such as vocational education or re-building relationships are often priorities. Relapse prevention education is essential in assisting the customer's recognition of triggers and warning signs of regression. Aftercare services help families and pro-social support systems reinforce a healthy living environment.

Comprehensive Community Service Team - Individual or Group
Comprehensive Community Service Team (CCST) services render assistance in identifying goals and making choices to promote resiliency and facilitate recovery for adults and children with mental illnesses. The services take place in either an outpatient or community setting. For individuals with mental health problems, recovery is the personal process of overcoming the negative impact of psychiatric illness despite its continued presence. CCST services are intended to restore the individual's function and participation in the community. The services are designed to assist and guide individuals in reconnecting with society and rebuilding skills in identified roles in his/her environment. The focus is on the individual strengths and resources as well as their readiness and phase of recovery. A team approach of services will be used to guide and support the adults and children served with development of a recovery plan focusing on the areas of individual and family living, learning, working and socialization activities. Any therapy is brief and oriented toward skill building. Services provided include Assessment, Case Management, Intensive Case Management, Supported Housing, Aftercare, Supported Employment, Outreach, Outpatient, In-home/On-site, Intervention, Information and Referral, Prevention, Prevention/Intervention and other transition and non-traditional support services as negotiated by the Department and the provider.

Day-night Services
These services provide a structured schedule of non-residential services for three (when Medicaid funded) or four or more consecutive hours per day. This may include delivery of services during evening hours. Activities for children and adult mental health programs are designed to assist individuals to attain the skills and behaviors needed to function successfully in the living, learning, work, and social environments of their community. Generally, a person receives three or more services a week. Activities for substance abuse programs emphasize rehabilitation, treatment, and education services, using multidisciplinary teams to provide integrated programs of academic, therapeutic, and family services.

Educational Services
Educational activities are provided in a variety of service settings. These include providing educational assessments; day treatment; case management; drop-in, self-help centers; and the Florida Assertive Community Treatment Team (FACT) program's specific educational service entitled Education, Support and Consultation to Family, and Other Major Supports. With the exception of the FACT-specific service for education, most educational services may be provided on-site of providers, with instructors funded through local school boards.

Florida Self-Directed Care
Florida Self-Directed Care is available in two parts of the state - the Jacksonville area and Southwest Florida. People eligible for public mental health services are given a budget and can choose the services and supports they want to buy, and from whom they will buy them. Their purchases have to be linked to a personal recovery plan, and some of the services have to be clinical. This program has served as a national model for similar efforts in other states.

Supportive Housing
Supported housing/living services are designed to help people with substance abuse or psychiatric disabilities find and keep living arrangements of their choice. They also provide services and supports to ensure continued successful living in the community. The goal of Supportive Housing is to ensure that everyone has the opportunity to live as independently as possible.

Supportive Employment
Supported Employment programs help people get or get back to productive employment. These services are community-based and take place in an integrated work setting, which provides regular contact with non-disabled co-workers or the public. A job coach provides long-term ongoing support as needed to give an individual every opportunity to maintain employment.

Mental Health Clubhouse
Clubhouses are structured, community-based interventions where members can strengthen and/or regain interpersonal skills, get psycho-social therapy toward rehabilitation, develop the environmental supports necessary to thrive in the community, meet employment and other life goals, and recover from the bad effects of a mental illness. Services are typically provided in a community-based program with trained staff and members working as teams to address the person's life goals and to perform the tasks necessary for the operations of the program. Clubhouses use a holistic approach focusing on a person's strengths and abilities while challenging that individual to pursue chosen life goals. Florida is invested in the International Center for Clubhouse Development (ICCD) model. Though there are other programs promoting employment across the system, Florida strongly encourages the ICCD approach and certification.

Residential Level 3
These are licensed facilities, structured to provide 24-hour a day, seven days per week supervised residential alternatives to persons who have developed a moderate functional capacity for independent living. For adults with serious mental illnesses, these are supervised apartments.


Support is practical, hands-on assistance to help people handle the necessities of daily living and assist them in their recovery process.

Florida considers the following services as support options:

Case Management
Case managers help people identify their needs, plan their services, link them to the service system, coordinate the various system components, monitor service delivery, and evaluating the effect of the services received.

Intensive Case Management
Same as above. Intensive case management is typically offered to persons who are being discharged from a state mental health treatment facility or crisis stabilization unit and in need of more support. They may also have more needs for things like rental or regular transportation assistance to help them live in the community.

Day Care Services
Day care services provide a structured schedule of activities for four hours or more consecutive hours per day for children of persons who are participating in a substance abuse or mental health day-night service or residential service.

Drop-In / Self-Help Centers
These centers are intended to provide a range of opportunities for persons with serious and persistent mental illnesses to independently develop, operate, and participate in social, recreational, and networking activities. Many are operated by consumers of mental health services.

Incidental Expenses
These may include the costs of medications that can't be paid for any other way, as well as things like clothing, medical care, educational needs, housing subsidies, or one-time expenses like the cost of turning on utilities for a new place to live.

Information and Referral
Provides information about resources in the community, and agencies/organizations that offer assistance; links people who need assistance with people who can provide it.

Prevention services involve strategies that avoid or put off the development of substance abuse and mental health problems. They include increasing public awareness through information, education, and alternative-focused activities.

Residential Level 4
The facility may have less than 24 hours per day, seven days per week on-premise supervision. This is the least intensive level of residential care and is primarily a support service. For adults with serious mental illnesses, this includes satellite apartments, satellite group homes, and therapeutic foster homes.

Respite Services
Respite service is an organized program designed to sustain the family or other primary care-giver by providing time-limited, temporary relief from the ongoing responsibility of care giving.

Room and Board with Supervision Levels 1-3
This pays room and board costs for people living in Medicaid-funded residential programs. Medicaid pays for the clinical services, and the SAMH program pays for the rest.