Assertive Community Treatment, Where Care Meets Community
For Nebraskans living with serious mental illness, the path to stability can feel overwhelming—especially when traditional outpatient services aren’t enough, but hospitalization isn’t the right fit. That’s where Assertive Community Treatment (ACT) steps in, offering a level of support that is both intensive and deeply rooted in the community.
Catherine Fletcher, Director of Program Development with Lutheran Family Services, has worked with ACT programs extensively during her career.
Fletcher said, “Recovery is possible for individuals living with severe mental illness when they receive consistent, person‑centered support grounded in respect and hope. Through more than fifteen years of work with ACT teams, I have seen how individualized, community‑based services empower people to build meaningful lives and pursue their goals.
Jennifer Sanders is the Director of Community-Based Services for the Eastern Lutheran Family Services Region. Sanders oversees a wide range of programs, but ACT stands out for its unique structure and its ability to meet people exactly where they are.
But at LFS, the vision goes beyond that.
What we really are hoping to do differently—and what our ultimate goal is—is that this program is where care meets community,” Sanders said. “We truly believe people are best served in the communities they live in.”
A Comprehensive Team for Complex Needs
ACT is built on a shared caseload model, meaning every staff member works with every client. This allows the team to respond quickly, collaboratively, and consistently.
The LFS ACT team includes:
• A licensed mental health clinician
• A licensed substance use clinician
• A vocational specialist
• A case manager
• A peer support specialist
• A medication provider
• A nurse
• A program assistant
• A team lead who manages daily operations
The team meets every weekday, and reviews clients enrolled in the program.
“They staff every single client every single day,” Sanders said. “It’s a daily touchpoint to make sure nothing falls through the cracks—updates, crises, priorities, everything.”
Frequency of contact is determined by individual recovery needs.
Who ACT Serves
ACT is designed for adults 19 and older who have a serious and persistent mental illness. To qualify, a person must have one of four primary diagnoses:
• Bipolar disorder
• Schizophrenia
• Schizoaffective disorder
• Major depressive disorder
They must also show:
• High utilization of emergency departments or inpatient psychiatric care
• Significant functional impairments in at least two of three areas:
• Activities of daily living
• Social skills
• Vocational functioning
Where ACT Is Offered in Nebraska
The LFS ACT program is staffed to serve 50 clients within a 75-mile radius of the Fremont CCBHC hub (1440 Military Ave), extending north, south, and west—up to the Nebraska state line.
“We can’t cross into Iowa, even though Council Bluffs is within 75 miles,” Sanders noted. “But we cover a wide area of eastern Nebraska.”
LFS also participates in a shared ACT program in the Lincoln region in partnership with CenterPointe.
An LFS ACT Client Story
When the client first connected with the ACT team, they were experiencing homelessness and frequent mental health crises that often led to hospital stays and police involvement. At that time, it was difficult for them to stay connected to treatment or feel supported in the community.
With help from ACT, the client was able to move into their own apartment, creating a sense of safety, stability, and independence. The LFS ACT team supports them with daily phone reminders for medication and increases check-ins during times when symptoms rise, helping the client feel supported and avoid crises.
Over time, the client has become more stable and has needed fewer hospitalizations. They are spending more time with family and rebuilding important relationships that matter to them.
As stability has grown, the client has begun focusing on personal goals beyond managing symptoms. With encouragement from ACT, they are exploring what a meaningful and satisfying life looks like for them, including strengthening family connections, maintaining their home, and building routines that support independence. The client continues working toward a future that reflects their values, hopes, and sense of purpose.
A Program Rooted in Community, Not Crisis
Sanders returned repeatedly to the heart of the program.
“We want our partners and our clients to know that our approach is simple: care meets community,” she said. “We meet people where they are, and we keep them in the communities where they’re best served.”
It’s a philosophy that reshapes what intensive mental health care can look like—less about walls, more about connection.
