Program of Assertive Community Treatment Marks 50 Years of Helping People with Mental Health Challenges

Fifty years have passed since a team of clinicians at today’s Mendota Mental Health Institute on Madison’s north side opened the Program of Assertive Community Treatment (PACT) in a house in downtown Madison, marking the beginning of the world’s first community-based mental health treatment service. This work revolutionized approaches to care and supports for people with mental health challenges in Wisconsin and beyond. The Wisconsin Department of Health Services (DHS) recognized this impact today, with an opportunity for people to visit with PACT staff and clients to learn about the evolution of PACT from a research project to one of the most effective approaches in community mental health care. From its modest beginnings in Madison, PACT’s model of care has been adopted across Wisconsin, in 41 states, and in 10 countries.

“We have much to celebrate today,” DHS Secretary-designee Karen Timberlake said at an event held at Mendota Mental Health Institute. “We are proud of the DHS staff, past and present, who have developed and refined a model of treatment that has offered hope, health, and healing to thousands of people here and around the world. They are innovators with the courage to do things differently when the status quo isn’t working. We also are proud of the accomplishments of PACT clients, past and present, who have allowed our teams to walk alongside them in their recovery journey. They’ve shown clinicians that, with the right care and supports at the right time, people living with a mental health challenge can transform their lives in meaningful ways. That’s the power of the PACT model. It helps the client dream about what they want to do and then implements a plan to get to that spot. Thanks to PACT, treating people with mental health challenges in their community is the norm today with a broad range of programs.”

PACT is the product of research in the 1960s at what was then known as Mendota State Hospital, which found that the progress made by people with mental health conditions at the hospital often went away when they were discharged, leading to repeat hospital stays. That is because the care and supports to maintain their health and wellness did not exist outside of the hospital.

The Assertive Community Treatment model of care is a team approach to providing the same type of ongoing, intensive round-the-clock services where the client lives, works, and plays, instead of in a hospital. Multiple providers with different specialties collaborate with each client to provide life coaching and assistance with problem solving for as long as needed. This model of care is best suited for people experiencing the most severe and persistent symptoms of bipolar disorder, psychosis, and schizophrenia with high level of need for services.

“At PACT, we see people beyond their mental health challenge,” said Dr. Jana Frey, Director of PACT. “We recognize the potential and power within them. Because of PACT’s support, clients can live more independently in their own communities.”

Services are adaptable to the client’s specific needs. Clients may receive help assessing and understanding their condition and symptoms, developing coping skills, managing medications, finding and keeping housing, getting and holding a job, and performing tasks of daily living like paying bills, shopping, and laundry.

Since accepting its first client on October 9, 1972, PACT has been the subject of dozens of clinical trials, with each study proving the model of care’s effectiveness in improving quality of life and reducing hospitalizations.

PACT serves people who live in Dane County under a contract with the Dane County Department of Health and Human Services, which refers and prioritizes people for admission.

The history of PACT is highlighted in a documentary and mural unveiled at today’s event. Watch the film and see a photo of the painting on the DHS website.