ABSTRACT
In search of a more effective way to aid persons with severe and persistent mental illnesses who cycled frequently between the hospital and the community, clinician-researcners in Madison, Wisconsin developed the Training in Community Living Program more than two decades ago. This program evolved into the Program for Assertive Community Treatment (PACT) (Stein & Test, 1975; Stein & Test, 1980; Test, 1979). Systematic evaluation has revealed the capacity of PACT to decrease hospitalization and enhance clinical and social outcomes at costs comparable to more traditional service delivery patterns (Weisbrod, Test & Stein, 1980; Olfson, 1990; Bums & Santos, 1995). Building upon this model, the project described here adapted the PACT approach to serve homeless persons with severe and persistent mental illnesses. The goal was to improve the capacity of the service system to serve a target population that was not adequately cared for by the existing array of services.
