ABSTRACT
The Program of Assertive Community Treatment (PACT) has been investigated in Madison and at other replication sites, and the positive results for clients have led to more widespread dissemination of the PACT model. This chapter presents a basic introduction to the model of care, research findings, and views on PACT model replication.
Subject(s)
Community Mental Health Services/organization & administration , Program Development , Community Mental Health Services/supply & distribution , Employment , Ill-Housed Persons , Humans , Male , Mental Disorders/rehabilitation , Models, OrganizationalABSTRACT
Use of nonprescribed mood altering substances is pervasive and problematic in young adults with serious mental illnesses in community care. Fifty-eight percent of young adult clients with clearly defined schizophrenia or schizophrenia-related disorders participating in a long-term community treatment study were rated by staff or themselves as using alcohol, cannabis, or other street drugs several times a week or more. We interviewed in depth a random sample of these "significant users" to obtain their perspective on their frequencies, patterns, histories, contributing factors to, and effects of substance use and their related treatment experiences. Results revealed these clients' substance use to be of long duration and deeply entrenched, with current use often involving multiple substances including both street drugs and substances of "everyday life" (e.g., caffeine, nicotine). Clients reported compelling reasons for use including anxiety reduction, relief of boredom, and a means for social contact. Staff and clients clearly view substance use quite differently, with the latter focusing at least as much on consequences of symptom relief as symptom exacerbation. Treatment implications are discussed.
Subject(s)
Psychotropic Drugs/administration & dosage , Schizophrenic Psychology , Adolescent , Adult , Attitude , Emotions/drug effects , Female , Humans , Illicit Drugs/administration & dosage , Male , Psychotropic Drugs/pharmacology , Schizophrenia/rehabilitation , Self MedicationABSTRACT
The authors describe the characteristics of 100 young adults with schizophrenia or schizophrenia-related disorders who are being treated in the community, patients who are at high risk for serious, long-term impairment but have not necessarily developed such impairment yet. In contrast to subjects in some other studies of young adult chronic patients, the patients show great variability in previous levels of functioning, such as employment history, ability to live independently, and drug use. The authors hypothesize that highly individualized assessment and comprehensive treatment provided early in the course of illness can prevent or limit chronic functional disability for many patients; they provide recommendations for such treatment.
