Advocacy group promotes unique treatment model for severe mental illness

The National Alliance for the Mentally Ill (NAMI) has launched an effort to make an individualized, unconventional treatment model for severe mental illnesses accessible to all Americans by the year 2002.

The Program for Assertive Community Treatment (PACT) is a multidisciplinary, team-oriented intervention that has proven effective for patients who haven?t benefited from traditional forms of outpatient treatment, NAMI says.

Only six states offer PACT statewide (Delaware, Idaho, Michigan, Rhode Island, Texas and Wisconsin), although demonstration programs are under way in 19 other states.

PACT teams provide clients with around-the-clock psychiatric and nursing care, vocational rehabilitation, behaviorally oriented skill teaching and help obtaining legal and advocacy services. Most of the treatment and rehabilitation takes place in the community, often at a client?s home or workplace, rather than in a hospital or other institutional setting.

PACT was created in the 1960s when researchers at a state hospital in Madison, Wis., decided that the hospital?s 24-hour-a-day care would be a valuable resource for clients once they returned to the community. PACT programs are locally run, and providers can set up programs in their communities.

NAMI members unveiled the initiative at an Oct. 6 congressional briefing. They say that research by the National Institute of Mental Health (NIMH), including a 1998 study in NIMH?s Schizophrenia Bulletin, confirms that PACT programs are more effective than traditional, clinic-based mental health services in reducing hospitalizations, homelessness and incarceration among people with severe mental disorders. Those enrolled in the program express a greater satisfaction with life, spend more time employed and less time in the hospital, and have more positive social relationships, studies show.

Only a few psychologists are members of PACT teams, but longtime Madison, Wis., team member Deborah Allness says all mental health professionals are valuable additions.

As part of its campaign to widen the program?s reach, NAMI will give state and county governments, grassroots advocates and federal authorities a manual that provides a description of the model and detailed instructions for operating a successful PACT program.

NAMI also wants to secure federal funding for PACT programs. (PACT operations already receive some support from state and local government funds.)

For more information about PACT, including information about joining a PACT team in your area, contact Elizabeth Edgar, NAMI?s Director of State Health Care at (703) 516-7973, or visit NAMI?s web site at www.nami.org.

?D. Peikin