Biomedical subjects

K R Lachance

Publications and source records attributed to K R Lachance.

3 recordsLinked to original sources

PubMed1995

Modifying the PACT model: preserving critical elements.

Few agencies have the resources to replicate the Program for Assertive Community Treatment (PACT) model pioneered in Madison, Wisconsin, which calls for around-the-clock, comprehensive treatment and rehabilitation services for persons with serious mental illness. Most agencies modify the model program, and little is known about patient outcomes in such altered programs. This paper discusses issues in modifying the PACT model, especially for use in rural areas. The authors focus on six basic elements of the PACT model: multiservice teams, 24-hour service availability, small caseloads that do not vary in composition, ongoing and continuous services, assertive outreach, and in vivo rehabilitation. They describe how programs in South Carolina that are adaptations of the PACT model have retained these elements and achieved desired outcomes with smaller teams operating on modified schedules.

Activities of Daily Living↗

PubMed1994

The response of an assertive community treatment program following a natural disaster.

A newly forming model treatment program for seriously mentally ill adults was dramatically affected by a natural disaster in September 1989. Hurricane Hugo rendered the offices of the Assertive Community Treatment Program uninhabitable, its vehicles marginally driveable, and its resources virtually nonexistent. In the three months following the storm, however, not a single psychiatric rehospitalization took place. Although the authors cannot claim that the program model was solely responsible for this outcome, this paper illustrates the service system elements that contributed to the program's effectiveness in the wake of one of the nation's most severe natural disasters.

Adolescent↗

PubMed1993

Providing assertive community treatment for severely mentally ill patients in a rural area.

OBJECTIVE: The authors' goals were to describe an assertive community treatment program developed for patients in rural South Carolina and to evaluate the effect of the program on rates of hospital utilization and cost of care. METHODS: Twenty-three patients with chronic psychotic disorders living in rural areas of South Carolina were assigned to an assertive community treatment program. The patients' average number of days per year in the hospital, length of stay per admission, number of admissions per year, and estimated annual cost of care during the five years before assignment to the program and during a period from four to 26 months after assignment were compared. RESULTS: The intervention was associated with a 79 percent decrease in hospital days per year, a 64 percent decrease in the number of admissions per year, a 75 percent decrease in the average length of stay per admission, and a 52 percent reduction in estimated direct cost of care. CONCLUSIONS: Although the methods of assertive community treatment may need to be modified to suit the travel requirements and other characteristics of rural settings, the study results suggest that the model can be successfully used in rural areas.

Adult↗