Partnering with the Durham Assertive Community Treatment Team

For my GradEngage project, I am partnering with Carolina Outreach’s Durham Assertive Community Treatment (ACT) Team, an organization that provides long-term mental health care alongside wrap-around social services – including psychotherapy, substance use counseling, peer support, and housing and employment assistance – to individuals with severe and persistent mental illness (SPMI) in their community and home settings. Their mission is to assist individuals with SPMI to improve all areas of functioning so that they can live independently and reach their full potential.

I first became interested in volunteering with Carolina Outreach’s Durham ACT Team during my four-week psychiatry rotation at Central Regional Hospital (CRH), a state psychiatric hospital in Butner, NC. After participating in the care of patients with severe and persistent mental illness at CRH, I grew curious about the type of psychiatric care these patients would receive once they were discharged from the hospital. Around this time, I was also looking for a community organization with which to volunteer, as I would have dedicated time for weekly community service through my medical school program, Duke’s Primary Care Leadership Track. From an internet search, I learned about local community mental health services offered through Carolina Outreach and reached out to see if I could be of service to their organization. A few short months later, I joined Carolina Outreach’s Durham ACT Team as a weekly medical student volunteer, gaining a greater understanding of the full spectrum of services they provide as I accompanied staff members to visit patients in their homes and in other community settings.

As we discussed how I might allocate my time as a volunteer, my ACT Team supervisor suggested that I focus my efforts on general health promotion among their patients, which became the framework for my current project supported by GradEngage. Individuals with SPMI are at increased risk for significant medical comorbidities, including diabetes and heart disease, that can decrease their life expectancy by up to 20 years relative to their counterparts without SPMI. Though the Durham ACT Team proactively connects their patients with primary care services, ACT Team members shared with me that some of their patients could benefit from more frequent discussion of healthy behavior change than is possible during a doctor’s visit. The Health Habits Awareness and Goal-Setting (HHAGS) Project was created to address this need by meeting patients where they are, both literally and figuratively, and offering individualized attention, time, and structure to work in partnership toward their health goals.

At the time of writing this post, I am about four months into the project, and I have been fortunate to work directly with two patients followed by the Durham ACT Team. Each meeting offers new opportunities for connection and reflection as we celebrate their progress and work together to create solutions to the challenges that they face in achieving their self-defined health goals. It has been a privilege to be able to share in this experience with both of them, and as I look ahead to the coming months, I am most excited about continuing to grow my relationships with my patient partners as we strive to make their goals of living healthier, happier lives their reality.