ACT was developed in the 1970s, as half a million patients dispersed from state psychiatric hospitals into private homes in American neighborhoods. This set off a vast churning: Patients stopped taking medication and deteriorated; were arrested or institutionalized; stabilized; and then were released to begin the cycle again. ACT, sometimes referred to as a “hospital without walls,” interrupted that cycle. It provided each client with a team of clinicians who were paid to make home visits and build relationships, sometimes delivering medications on a daily basis. Researchers have found this approach can reduce emergency hospitalizations by anywhere from 40 to 80 percent. Above: The Fort Hall Reservation of the Shoshone-Bannock Tribes in Fort Hall, Idaho