Anthony Penn

Program Manager

20 W. Bank Street, Suite 6
Petersburg, Virginia 23803
Phone: (804) 722-4299
Fax: (804) 722-4290
Email: apenn@d19csb.com

The PACT program is comprised of multidisciplinary mental health professionals organized as a mobile unit to provide the treatment, rehabilitation, and support services that persons with severe mental illnesses need to live successfully in the community. The PACT program is also a licensed Intensive Community Treatment (ICT) program.

The primary goals of PACT treatment are:

  • To lessen or eliminate the debilitating symptoms of mental illness each individual client experiences and to minimize or prevent recurrent episodes of the illness.
  • To meet basic needs and enhance quality of life.
  • To improve functioning in adult social and employment roles and activities.
  • To increase community tenure.
  • To lessen the family's burden of providing care.

It is important to emphasize that PACT is not a "linkage" or "brokerage" case management program that connects individuals to services provided by multiple mental health, housing, or rehabilitation agencies or programs in the community. The PACT multidisciplinary staff works as a "team"   not a group of individual practitioners who operate in the context of a case management program and have primary responsibility only for their caseloads. The PACT team works collaboratively to deliver the majority of treatment, rehabilitation, and support services required by each client to live in the community. The team provides these necessary services 24 hours a day, seven days a week, and 365 days a year.

Intensive Community Treatment Service Description & Eligibility Requirements

Primary Provider of Services and Fixed Point of Responsibility

The PACT team is the primary provider of services and has the responsibility to help clients meet needs in all aspects of living in the community. Having one team provide all key services minimizes the "fragmentation" and time-consuming coordination characteristic of traditional mental health systems in which there are multiple agencies and programs, each addressing only part of a client's needs for housing, employment services, or therapy.

Services Provided Out Of Office

The majority of PACT treatment and rehabilitation services take place in the community — that is, in the client's own residence and neighborhood, at employment sites in the community, and in the same places most people spend their leisure time. This mobile approach minimizes dropout of clients, enables the provision of psychosocial services wherever clients need to use them, and eliminates the need for transfer of learning, which has been difficult to achieve in persons with serious mental illnesses.

Highly Individualized Services To The Client

Individualization of treatment across clients and across time is fundamental to the PACT model given the great diversity among persons with severe mental illnesses and the fact that both clients and psychiatric conditions are changing. Individualization can occur only if the staff put in the time to really know the person and his or her family. Treatment interventions are tailored to address the current needs and preferences of the each individual rather than assigning clients in groups to "programs".

An Assertive "Can Do" Approach

The PACT multidisciplinary clinical team assumes the responsibility to do whatever needs to be done to assist a person with mental illness in meeting his or her individual goals and service and treatment needs. The PACT team works to adapt the environment and themselves to meet the client's needs rather than requiring the client to adapt to or follow the rules of the treatment program. The rules ... for acceptable community behavior the PACT model uses are the general rules and responsibilities that apply to all citizens in the local community. In addition, the PACT team continuously provides the energy, persistence, and unconditional emotional support that clients need to develop, try, and evaluate more effective strategies and interventions to meet their individual aspirations and treatment and rehabilitation needs.

Continuous Long-Term Services

PACT services are delivered in a continuous rather than time-limited framework. The first major controlled study of PACT found that clients did well while receiving PACT services, but relapsed or showed loss of treatment gains following discharge from the program. Even very intensive, community-based treatment cannot "cure" severe mental illness, but the PACT model can provide a system of care within which persons with severe mental illness can live and thrive.

The Scope Of The Program

The PACT model is indicated for adults with severe and persistent mental illnesses, which are psychiatric disorders that cause symptoms and impairments in basic mental and behavioral processes. These symptoms and impairments produce distress and major functional disability in adult role functioning (e.g., employment, self-care, and social and interpersonal relationships). Clients are not excluded from PACT services because of severity of illness, disruptiveness in the community or the hospital, or failure to participate in or respond to traditional mental health services (e.g., outpatient therapy, day treatment). PACT clients may be voluntary or admitted under court commitment.

PACT services are intended primarily for individuals with psychiatric illnesses that are most severe and persistent, including the following psychiatric diagnoses from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, of the American Psychiatric Association (DSM IV):

  • Schizophrenia
  • Other psychotic disorders (e.g., schizoaffective disorder)
  • Bipolar disorder

In addition, PACT services are appropriate for some people who experience significant disability from other disorders, such as obsessive-compulsive disorder, anorexia nervosa, borderline personality disorder, and dissociative identity disorder, and who have not been helped by traditional mental health services.

The program gives priority to referrals with a history of a) severe and persistent mental illness, b) significant functional disability, and c) a history of recurring state psychiatric hospitalization.

Services

The PACT team provides comprehensive, individualized services in an integrated, continuous fashion for persons with severe and persistent mental illnesses, including:
  • Treatment for the primary manifestations (i.e., symptoms and impairments) of the illness itself.
  • Rehabilitation to help each person build his or her strengths and cope with the effects of mental illness on adult activities (e.g., employment, home life and activities of daily living, and social and interpersonal relationships).
  • Emotional and practical support to help individuals sustain a good quality of life and negotiate complex social and health care systems.

The elements of PACT treatment are:

  • Psychopharmacological treatment,
  • Individual supportive therapy,
  • Substance abuse treatment,
  • Crisis intervention,
  • Psychiatric hospitalization.

Rehabilitation services include assistance with:

  • Employment and structuring time,
  • Activities of daily living,
  • Social and interpersonal relationships, and
  • Use of leisure time.

Support services include:

  • Advocacy, coordination, side-by-side individualized support, direct assistance, training, and supervision to help the client obtain and maintain resources needed to maintain community tenure, good quality of life, and achievement of personal goals.
The program serves adults in the Tri-city area (Petersburg, Colonial Heights, Hopewell), as well as in surrounding counties served by the District 19 Community Services Board, to include Prince George, Dinwiddie, Sussex, Surry, and Emporia.

(Program description adapted from: Allness, D. & Knoedler, W. (1998). A Manual for PACT Start-Up. Arlington, VA: National Alliance for the Mentally Ill.)