Mclean Hospital

Program of Assertive Community Treatment (PACT)


At McLean Hospital, we understand that care doesn’t end when someone leaves the hospital. Our Program of Assertive Community Treatment (PACT) brings clinicians into individuals’ homes and local communities to best meet the ongoing needs of people with psychotic disorders such as schizophrenia, bipolar disorder, and psychosis. Designed to support those at risk for repeated hospitalizations, PACT provides the clinical services a person needs to keep up with their treatment and the independent living skills they need to navigate day-to-day life. Our experienced treatment team collaborates with other services and resources—at McLean and in the individual’s community—to ensure continuity of care.

For information or to make a referral, please call 617.855.2674.

PACT is best-suited to adults 18 years and older who are:

  • At risk for repeated hospitalization or in need of recovery supports
  • Seeking individualized and person-centered treatment that is flexible and adaptable to one’s goals and needs
  • Struggling with staying on track with their treatment or need help with skills for day-to-day living including vocational and social skills
  • In need of person-centered care and access to a compassionate mobile treatment team

At PACT we do not define our patients by their illness. Instead we recognize that these individuals are people who can create a meaningful life. We meet people where they are, both mentally and physically, and by helping individuals get the right supports in place, we empower our patients so they are an active participant in their care and in their life.

A lack of accessible care and care continuity can mean that many people do not receive the help they need so that they can function in society and achieve their goals. Doctors and researchers have long understood that people receive wraparound care while they’re in the hospital, but they don’t always get that care after discharge, often resulting in another hospital stay. Programs like PACT bridge the gaps in care and have been successful at reducing number, frequency, and length of hospital admissions. Studies show that individuals who have taken advantage of similar programs spend less time out of work, earn more money, and have more fulfilling social lives. Services like PACT can also reduce caregiver burnout by adding resources to patients’ support systems.

The goal of our program is to decrease the frequency and duration that an individual spends in a high level of care. We provide comprehensive and ongoing clinical support, assessment, rehabilitation assistance, and general help with daily life. Our services are designed to facilitate easy and rapid access to the PACT team in order to manage symptoms proactively, intervene in a crisis, and prevent further decompensation.

Individuals may need help for only a month, or they may need longer-term, more comprehensive assistance. Though the minimum length of participation in this self-pay program is one month, PACT is flexible in order to meet the needs of the patient. The program strives to provide customized, person-centered care for individuals at any stage of the rehabilitation process.

“[The PACT staff] are always accessible. They believe in me. They are observant. They see me beyond my illness. Because of PACTs indispensable support, I now live more independently with some additional care.”– Program of Assertive Community Treatment patient
PACT in the News

Read more about McLean’s newest clinical program in the article “Hospital Without Walls for Individuals With Chronic Mental Illness.”

PACT is supported by philanthropy. Read more about Monica Luke and the PACT program in the article “New PACT Team Offers Support 24/7.”

Support and Services

McLean’s PACT is structured to make sure people with psychotic disorders receive the help they need, when they need it, and for as long as they need it. As a “hospital without walls,” members of PACT’s community-based team offer services aimed at assisting patients as they transition between levels of care or to help avoid the need for hospitalization. Our clinicians address symptoms and focus on assisting with therapy and medication management. We also place equal emphasis on helping to build and grow facets of an individual’s life that are important to recovery, such as community integration and independent living skills.

PACTBy conducting patient care in the community, the program not only provides support to help reduce the chances of readmissions, but also gives an individual the chance to become a partner in their own care. We collaborate with the patient to develop a service plan that incorporates the individual’s treatment and personal goals.

Participants in PACT may benefit from the program’s low patient-to-staff ratios, a high frequency of contact between the patient and clinicians, direct service provision from the PACT team, outreach in the community, and access to a medication prescriber. PACT uses open dialogue/dialogic practice and emphasizes a flexible person-centered approach focused on shared decision-making and peer support.

PACT provides assistance with all aspects of treatment including medications, therapy, crisis intervention, peer support, and more. With a focus on rehabilitation, an individual can work with the PACT team to develop or enhance skills to benefit work or personal life. Rehabilitation is achieved by not only treating symptoms but by building up one’s life outside of traditional mental health treatment.

The PACT team works with patients to help identify and achieve goals for sustained, ongoing recovery and independent living, including helping to establish routine and structure, find a job, develop new interests, and become connected to their community. We can help individuals learn skills such as how to manage money, utilize public transportation, or shop for groceries. PACT offers assistance with obtaining support services and benefits such as financial and educational services, and legal assistance.

PACT also includes services such as social skills coaching, symptom education, vocational rehabilitation, family support and education, ADL coaching, coping skills development, community integration assistance, and 24/7 crisis on-call access.

Treatment Team

Program Leadership

Chloe Pedalino, LICSWChloe Pedalino, LICSW, Program Director

Ms. Pedalino is also the director of Collaboration and Community Liaison for the Psychotic Disorders Division at McLean Hospital. A co-founder of the Psychotic Disorders Mentorship Program (PDMP), she previously worked as a clinical social worker at McLean’s Schizophrenia and Bipolar Disorder Inpatient Program, where she served as a lead clinical social worker.


Joseph Stoklosa, MDJoseph Stoklosa, MD, Clinical Director, Psychotic Disorders Division

Dr. Stoklosa is also the assistant program director for the MGH/McLean Adult Psychiatry Residency Training Program and is an instructor in psychiatry at Harvard Medical School. He is actively involved in educational research and founded the Clinician Educator Program for the MGH/McLean residency program. Dr. Stoklosa also developed the Schizophrenia and Bipolar Disorder Inpatient Program’s clinical care model, which is focused on improving the use of evidence-based treatment.


Staff and Associates

Our staff includes experienced and well-trained social workers, psychiatric nurse practitioners, a peer counselor, and more. They have extensive background in the treatment of chronic and persistent mental illness such as schizophrenia and bipolar disorder, as well as experience working with patients from diverse cultural and socioeconomic backgrounds from across the country and around the world.

PACT is a community-based program within McLean’s Psychotic Disorders Division, under the leadership of Dost Öngür, MD, PhD.

Admission & Cost

Admission

The Program of Assertive Community Treatment (PACT) is a community-based treatment program for adults with chronic mental health diagnoses—such as schizophrenia, bipolar disorder, psychosis, and other related disorders—who would benefit from access to comprehensive treatment team and crisis on-call services offered in the individual’s home or local community.

For further information or to make a referral, please contact:

Chloe Pedalino, LICSW, Program Director
Phone: 617.855.2674
Email: cpedalino@partners.org

We evaluate individuals prior to admission to ensure the program is a good fit, which includes meeting a specific set of criteria. Potential program participants or referring clinicians should fill out and return the PACT Referral Form. If you need assistance with the admission process, please contact the program using the information provided above.

Cost

PACT is a self-pay program. The rate is $1,500 per month, which covers all services provided by the PACT team. Services provided by other McLean Hospital programs or by programs in an individual’s community are not included in this fee, but are likely covered by health insurance.

FAQ

Where is PACT located?

The PACT program is based at McLean’s Belmont, Massachusetts campus. However, PACT is a community-based program, and care and services are delivered in the individual’s home or community, as appropriate.

Who benefits most from PACT?

PACT is designed to help adults with psychotic disorders such as schizophrenia, bipolar disorder, psychosis, and other related disorders. The program is aimed at individuals who need assistance to stay on track with their treatment or need help with skills for day-to-day living, including vocational and rehabilitation skills.

Is family involved in treatment?

Family involvement is up to the individual. Family can be an integral part of one’s treatment and sustained recovery. With permission of the patient, we include family members in treatment to the extent that it is clinically appropriate.

Is aftercare planning a part of the program?

The treatment team works closely with the individual as well as with family, significant friends, and outside providers to develop a personalized aftercare plan. Recommendations by staff are made based upon clinical needs, progress made during treatment, and long-term treatment goals.