Program for Assertive Community Treatment (PACT)
If you know someone who might benefit from Program for Assertive Community Treatment (PACT) services:
Download the PACT Referral Form and submit it with a clinical assessment documenting diagnosis of a severe psychotic disorder such as schizophrenia, schizoaffective disorder, or bipolar affective disorder with psychotic features
Download the King County PACT brochure, review it with the individual, and ask for their consent to refer them to this service
The Program for Assertive Community Treatment (PACT) is an intensive, team-based behavioral health service package which offers individualized support in the community to people with severe mental health conditions and high service needs. PACT assists participants in their recovery from mental illness and in developing fulfilling lives, as well as increasing their time and engagement in community settings rather than institutions such as hospitals and jails.
PACT teams are made up of a variety of service providers who assist individuals with meeting basic needs like housing, finding and keeping employment, improving social connections, sustaining independent living, and pursuing their personal goals. The team also offers an array of behavioral health treatment options including evidence-based psychotherapies and supportive counseling, medication management, nursing and healthcare coordination, peer support, crisis intervention, and treatment for co-occurring substance use and mental health conditions. All services are tailored to a PACT participant’s unique needs and goals.
PACT offers coordinated treatment by a team of behavioral health specialists including a psychiatrist or ARNP, nurse, chemical dependency specialist, employment specialist, mental health counselors, case managers, and a peer support specialist. Some of the key elements of PACT include:
- Small caseloads with a ratio of about 10 participants per staff person
- Centralized, integrated care where the PACT team provides coordinated treatment across specialties
- Most services are provided in the community where participants live
- Services are provided as long as they are needed rather than ending on a fixed date
- Services are flexible and are based on individual needs
- Staff are regularly scheduled to offer behavioral health services 8 to 12 hours a day, 7 days a week
- Crisis services are available 24 hours/7 days a week
The Assertive Community Treatment model was developed in the early 1970s in Madison, Wisconsin as a robust outpatient service system to facilitate deinstitutionalization and assist people with severe mental health conditions in moving from long-term state hospitals to community settings. It has since been replicated and adapted nationally and internationally with a large body of research supporting ACT’s efficacy in reducing hospital and jail recidivism and length of stays, increasing community tenure and perceived quality of life, and diverting individuals at risk of long term hospitalization.
ACT is one of the six practices endorsed by the "Evidence Based Practice Project" sponsored by the Robert Wood Johnson Foundation, the federal Substance Abuse and Mental Health Services Administration (SAMHSA), and National Alliance for the Mentally Ill (NAMI).
Washington State adopted the ACT model in 2007 through implementation of a state-wide PACT network and provided program standards and eligibility criteria. PACT services in WA are supported by Medicaid and state funds and administered locally.
The ACT model includes a stakeholder advisory body made up of community partners and at least 51% representation by people with lived experience of mental health conditions and their families which supports team operations and informs policy decisions. In King County, the Behavioral Health and Recovery Division facilitates a Stakeholder Advisory Group quarterly with representation from Western State Hospital, Harborview, Jail Health Services, consumer advocates with lived experience, and leads, peer support specialists, and participants from each local PACT team.
More information about PACT at national and state levels
- University of Washington PACT training and fidelity monitoring
- Washington State DSHS
- SAMHSA’s National Registry of Evidence-based Programs and Practices
King County has a total of 270 spaces available for PACT participants. Per ACT national standards, each team enrolls up to four to six consumers per month. Local services are part of a state-wide PACT network which receives training and fidelity monitoring by the University of Washington Department of Psychiatry and Behavioral Sciences, Evidence-Based Practices for Adults.
King County operates three PACT Teams:
- Downtown Emergency Service Center (DESC)
- Pioneer Human Services
Contact Shanna Clinton, King County PACT Project Manager at 206-263-5747 or firstname.lastname@example.org.