Falling Through the Cracks

Posted on October 6, 1998

Washington, D.C. - Frustrated by this Nation’s continued failure to provide effective care and treatment for individuals with the most severe mental illnesses, the National Alliance for the Mentally Ill (NAMI) today announced a bold initiative that will seek to bring a proven treatment program to every state by the year 2002.

The new NAMI initiative focuses on the Program for Assertive Community Treatment (PACT) model. Hailed by experts as a critical component of care for those who do not respond to traditional methods of treatment, PACT draws from over 25 years of documented success and provides highly individualized psychiatric, social work, nursing, and vocational rehabilitative services. “Despite the program’s repeated and unequaled success and twenty-five years of confirming research by the National Institute of Mental Health, its replication in public mental health systems has been agonizingly slow,” said Laurie Flynn, NAMI’s executive director. “Far too many of those who could benefit from PACT have no access to the services that would allow them to live successfully in our communities.”

This announcement comes two months after the tragedy involving Russell Weston, Jr., on Capitol Hill and a recent call by members of Congress for the creation of a Congressional Task Force on Mental Illness to probe the consequences of not adequately treating individuals with the most severe of mental illnesses.

NAMI Status Report on Lack of PACT Availability At a Congressional briefing for members of Congress, their staffs, and media representatives, NAMI reported that only a fraction of those with the greatest needs have access to this uniquely effective program that has been proven to reduce homelessness, hospitalizations, and jail time among people with serious brain disorders. Only six states currently offer PACT statewide; these states are Delaware, Idaho, Michigan, Rhode Island, Texas, and Wisconsin. An additional 19 states and the District of Columbia are implementing PACT demonstration programs, but these alone cannot come close to meeting the needs of the thousands of people who can benefit from PACT.

NAMI PACT Initiative

NAMI announced a five-part strategy designed to establish PACT programs in every state by the year 2002:

• The centerpiece of the NAMI initiative is the new NAMI manual, The PACT Model of Community-Based Treatment for Persons with Severe and Persistent Mental Illnesses. This first-of-a-kind manual provides detailed instructions for starting and operating a successful PACT program. NAMI will distribute this manual to state Medicaid agencies, state and county mental health authorities, the Health Care Financing Administration, legislators and other policy makers, and to its grassroots advocates.
• NAMI will distribute a PACT advocacy guide to all NAMI members that will provide specific steps for pushing at the state and local levels for PACT programs. NAMI will also provide support and training for NAMI grassroots leaders.
• In conjunction with its 20th anniversary celebration, NAMI will sponsor a national symposium that will bring together states that have successfully implemented PACT with states yet to use the PACT model.
• NAMI will seek congressional action to replicate the PACT model through expanded funding and program targeting, such as establishing a requirement in the Mental Health Block Grant for states to provide PACT programs. NAMI will also work with the Health Care Financing Administration on funding mechanisms for PACT.
• Finally, NAMI will establish and support a cadre of expert PACT consultants who will assist states, providers, and health plans to implement and oversee the model.

“Making our new start-up guide widely available is the first step in bringing new opportunities to all consumers who may benefit from the chance PACT offers to lead meaningful and dignified lives,” said Flynn. “We will then dedicate the full support of NAMI to helping families advocate in their own communities so that this proven successful treatment program can fulfill its promise.”