Programs of Assertive Community Treatment: Oklahoma’s unmet needs and opportunities to expand intensive services

Program of Assertive Community Treatment, or PACT, is a model for intensive community-based care for people with serious mental illness, such as schizophrenia or bipolar disorder.

PACT teams tend to serve people who are high utilizers of hospital services or who frequently interact with the criminal justice system. Without access to PACT services, these people often cycle in and out of inpatient care, emergency rooms, jails, or prisons.

Our newest research finds that Oklahoma’s PACT teams serve less than half the number of people who would benefit from and be eligible for these services.

With 11 PACT teams that serve a total of 750 to 800 people a year, Oklahoma simply does not have enough PACT coverage to meet demand.

Our report highlights Oklahoma’s unmet need for PACT and Forensic Assertive Community Treatment (or FACT) services, ways to improve admissions and discharges from these teams, as well as differences between PACT and other intensive treatment models.

Key findings

• PACT teams serve less than half of the roughly 1,800 Oklahoma adults estimated to be eligible for and benefit from these services.  
• Oklahoma’s mental health agency should reverse course on its strategy to de-emphasize PACT and instead adopt a goal of statewide PACT coverage.  
• Very few Oklahomans graduate from PACT teams to lower levels of care, contributing to a “PACT for life” mindset that can be detrimental to clients and the broader behavioral health care system. Oklahoma should establish a statewide, standardized procedure for graduation from PACT teams to lower levels of care.
• Oklahoma should expand the support offered by PACT to people who frequently encounter the criminal justice system by establishing forensic Assertive Community Treatment teams. Forensic ACT teams include staff members with criminal justice knowledge and are better equipped to address risk factors for recidivism.
• Oklahoma should commit to data tracking for PACT teams’ quality and outcomes. With better data, researchers and policymakers can develop the information necessary to make strategic investments in PACT, determine where it will be most beneficial, and help people get treatment at the appropriate levels of care.
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