Assertive Community Treatment (ACT)
PACT and Medication
Do all PACT members take medications?
When NAMI folks refer to PACT, we mean the program of assertive community treatment described in the PACT Model of Community-Based Treatment for Persons with Severe and Persistent Mental Illnesses: A Manual for PACT Start-Up, ("the PACT manual," for short) and in the National PACT Standards.
PACT teams are made up of a psychiatrist, social workers, peer specialists (people who are receiving or have received services for severe and persistent mental illness who are paid PACT staff), nurses, paraprofessional mental health workers, employment specialists, and substance abuse specialists. A qualified person who is recovering from a severe mental illness can hold any staff position on a PACT team. Many consumers find employment on an assertive community treatment team satisfying work.
Many people have questions about the role of medication in assertive community treatment. Two questions they ask most frequently-and the answers-are:
In PACT, do consumers have to take meds?
No. PACT consumers have choices, including a choice about taking medications. If a consumer does not want to take medication, he or she is not discharged or abandoned. PACT continues to work with consumers who do not want medications in other ways, such as with finding housing or a job or managing symptoms without medications.
Courts sometimes do order people to take medications, so some PACT members are legally required to follow that treatment. These people would have that requirement no matter where they got services, in a PACT program or in any other community mental health program.
Remember that people in the PACT program have supportive, give-and-take relationships with staff, including staff who are themselves recovering from a severe mental illness and know first-hand the benefits of and problems with taking meds. And staff can help people avoid involuntary hospitalization, homelessness, or returning to jail or prison.
If consumers do choose to take medication, do PACT staff come to their house every day to bring the meds and make sure they take them?
PACT teams do not deliver medications to most PACT consumers' homes. Rather, consumers develop their own individual strategies with staff help. When both agree medication would be helpful, they work out a strategy and schedule that make the best use of the medication's benefits, that works well with the consumer's daily routine.
Some strategies consumers use include things like putting medications in special containers so they're sorted by days or weeks to make it easier to remember to take them correctly. Sometimes staff just give reminders or arrange for the consumer pick up meds at the PACT team's office, if he or she wants to do that. And, yes, sometimes staff will deliver medications to a consumer's residence daily if that's what the consumer and staff think will work best.
The goal in PACT is for people who take medication to learn manage it on their own as part of their recovery.
Medication, when it's needed, is just one tool staff and consumers may use when they're working together for a better life for the consumer. Staff and consumers know it's just a single tool among many--like getting and keeping a place to live, or finding and staying in a job or in school, or learning to be comfortable with friendships and social activities. Like medication that helps with symptoms, all are ways to get better. When consumers and staff learn to use many tools well and make changes when individuals need a change, they are on their way to better managing their health and their lives.