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MMHI: Program of Assertive Community Treatment (PACT)

The Program of Assertive Community Treatment or PACT uses a team approach to provide comprehensive, community-based psychiatric treatment, rehabilitation, and support. The model of care is designed for people that have a very serious mental illness with symptoms that get in the way of everyday life. The goal of the program is to help clients maintain their health and safety in the community by helping them achieve their recovery goals.

The services that PACT provides are customized for each client. The program is structured to make sure clients get the help they need, when they need it, and for as long as they need it. The services focus on addressing symptoms and developing independent living skills needed to navigate day-to-day life.

PACT serves people who live in Dane County. The Dane County Department of Health and Human Services refers and prioritizes people for admission.

From project to movement

PACT evolved from the work of Arnold Marx M.D., Leonard Stein, M.D., and Mary Ann Test, Ph.D., on an inpatient research unit of Mendota State Hospital (today's Mendota Mental Health Institute) in the late 1960s. They found that gains made by people with mental health conditions in inpatient settings often went away after discharge. People treated in inpatient settings were frequently readmitted to the hospital. They believed that round-the-clock hospital support lessened symptoms but to maintain the improvement ongoing support was critical following discharge.

To test their assumptions, the researchers moved hospital unit staff into the community. In 1972, they rented a house in downtown Madison, a few miles from the hospital on Madison's north side. The new unit was called PACT. The program maintained 24-hour staffing with professionals from multiple specialties to provide intensive care and treatment. Staff supported PACT participants in their homes, on the job, and in social settings. This model revolutionized the approach to services for people with severe mental illnesses, putting the emphasis on provider-client relationships with a life coach method. The first client was accepted October 9, 1972. PACT is widely regarded as the first effort to provide comprehensive mental health care in a community setting.

The model of care pioneered by PACT is now available across Wisconsin, in 41 states, and in 10 countries.

Multiple studies have confirmed the benefits of the PACT approach in improving the quality of life of people with severe mental illness.

Proud past, promising future

To mark 50 years of PACT in 2022, PACT staff, clients, and supporters worked together to produce a documentary that highlights PACT's storied history. Watch it below.

The video was directed by Jana Frey, produced by Jacob Ahrens-Balwit, and edited by Jacob Ahrens-Balwit and Christine Ahrens. Fred Schubert provided the music. Karney Hatch provided the drone video.

In recognition of PACT's 50th anniversary, Governor Tony Evers proclaimed October 9, 2022, PACT Day in Wisconsin (PDF).

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Mendota Mental Health Institute
Program of Assertive Community Treatment
600 Williamson Street, Suites A and B
Madison, WI 53703
608-261-8085 - Fax

Last revised January 30, 2024