Occupational therapists can play a valuable role on Assertive Community Treatment Teams (ACT). ACT is a widely disseminated, community based model of service delivery for individuals with severe psychiatric disabilities and high support needs. This paper discusses the generalist and specialist functions of occupational therapists within ACT. It is argued that occupational therapy addresses the occupational health and well being of ACT clients by intervening at three levels: the individual, the program and the community. This occupational focus is consistent with the ACT goal of enhancing community adjustment and quality of life. The paper concludes with a discussion of the opportunities and the constraints that face occupational therapists working within ACT.