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OLYMPIA -- The Department of Social and Health Services (DSHS) has completed the launch of special Program for Assertive Community Treatment (PACT) teams in nine regions of the state, bringing a new dimension to mental health services for individuals with severe and persistent mental illness and co-occurring disorders like alcoholism or substance abuse.
The implementation of PACT teams will be complemented by the development of other community alternatives for state hospital patients as DSHS continues to implement a comprehensive package of mental health initiatives that will boost the use of evidence-based practices and upgrade delivery of public mental health care statewide.
"The PACT concept is aimed at serving individuals with significant psychiatric disabilities whose needs have not been met by going to the local mental health center. The model allows for extensive outreach, which is key to supporting individuals who cycle through psychiatric hospitals and is why we are setting our hopes so high," said Andy Toulon, Supervisor of the Office of Planning, Development and Initiatives in the Mental Health Division (MHD) of the Health and Recovery Services Administration at DSHS.
"Access and individualized supports – both are the keys," said Maria Monroe-DeVita, Ph.D., Director of the Washington Institute for Mental Health Research and Training (WIMHRT). Monroe-DeVita was a key consultant in getting the PACT operation under way.
"Services are available 24 hours a day and seven days a week, and three-quarters of the team's contacts are provided at individuals' homes or other community locations which are convenient for those being served," she said. "All services support recovery with the goal of facilitating reintegration into the community."
The PACT teams, modeled on an approach used successfully in dozens of other states, should bring:
In addition, DSHS will measure the impact of this model on employment and criminal justice outcomes.
PACT is an intensive approach -- community-based, recovery-oriented, and consumer-centered. It is one of the most extensively researched evidence-based practices in mental health.
PACT teams include multi-disciplinary staffing, with team members sharing the responsibility of addressing different consumer needs. Low caseloads – ideally in the range of a 1:10 staffing ratios – help ensure individualized care and frequent contacts. A typical team in an urban setting will include a team leader, psychiatrist, three to five registered nurses, four mental health professionals, a vocational specialist, a substance abuse specialist, and a peer support specialist.
The urban teams will serve approximately 80-100 individuals. Rural teams have the same types of professionals but are smaller and serve 42-50 individuals.
The PACT teams' focus is on individuals with a history of frequent psychiatric hospitalization and crisis services.
"These are people who have difficulty benefiting from traditional services, or who may have a high risk or history of arrest and incarceration," Toulon said. "Priority will be given for patients appropriate for discharge from Western and Eastern State Hospitals – one payoff being the goal of closing four wards between the two state hospitals over the next biennium."
A total of 15 mental health agencies in nine Regional Support Networks (RSNs) are involved in implementing PACT teams in the first wave of implementation. PACT’s funding is for $10.4 million a year. The teams received extensive training and ongoing technical assistance through WIMHRT, which is funded by the MHD to support the teams.
Western Washington counties involved include King, Pierce, Snohomish, Thurston, Mason, Kitsap, and Clark. Eastern Washington counties with teams include Spokane, Benton, Franklin, Chelan, and Douglas.
"We are counting on these teams to produce the same kind of success that other states have reported after implementing PACT services," Toulon said. "It will enhance the lives of some of our most vulnerable citizens."
What is a PACT Team?
PACT teams are multi-disciplinary programs that focus on hard-to-serve individuals with high use of psychiatric hospitalization and crisis services. Priority goes to patients appropriate for discharge from Western and Eastern State Hospitals. A fact sheet on PACT teams is available on request from stevejh2@dshs.wa.gov
FOR MORE INFORMATION:
Visit the PACT Web site: http://www1.dshs.wa.gov/Mentalhealth/sti_pact.shtml
Jim Stevenson, Communications Director, HRSA, DSHS, 360-902-7604 (Pager: 360-971-4067).
