As a grantee in our Behavioral Health Continuum of Care Initiative, the Eastern Montana Community Mental Health Center (EMCMHC) is changing how mental health and support services are provided – and accessed – in Eastern Montana. Through the Program for Assertive Community Treatment (PACT), small teams of health professionals travel into the community and provide care for people struggling with mental illness. By making it easier for people to get the mental health treatment and support services they need, PACT works to keep people living safely in their homes and communities – and out of hospitals and jails.

The Program for Assertive Community Treatment

We are working to strengthen Montana’s behavioral health prevention and treatment system through our Behavioral Health Continuum of Care Initiative. This strategic initiative seeks to improve access to effective prevention programs and effective treatment for mental illness and substance use disorders.

PACT is a behavioral health delivery model designed specifically for rural and frontier areas that offer community-based treatment to help people with mental illness live and function well in the community. PACT teams are made up of multidisciplinary groups of licensed staff and paraprofessionals available anytime to go out into the community and provide care for people wherever they are.

By providing community-based mental health treatment and connections to other health and social services, PACT helps people with longstanding, severe, or disabling mental illness to live and function safely in the community.

Community-Based Treatment in Eastern Montana

Based out of Miles City, EMCMHC has provided mental health services in Eastern Montana for the past 53 years. Traditionally, it has worked the way many mental health centers do – by providing therapy and case management to clients who come into their offices. However, this way of delivering care is problematic in Eastern Montana. With a service area that spans 48,000 miles and 17 frontier counties, distances between communities are extreme, and those who need help the most may have a limited ability to travel.

EMCMHC knew that if it were going to reach people who need services the most, it would have to be innovative. PACT provided a solution.

With support from the Behavioral Health Alliance of Montana, the Addictive and Mental Disorders Division, and a $200,000 grant from the Montana Healthcare Foundation, EMCMHC started its PACT program in 2020.

EMCMHC began by making internal changes to its business model and workflows. Rather than providing broad outpatient therapy, it shifted its internal structure to focus on higher-level services that specifically target community needs. It also strengthened its partnerships with other community organizations, including health care, social services, and law enforcement.

It’s exciting to see the number of primary care and dental appointments our MACT teams are getting people into. Our clients haven’t had access to these services before, so it’s really fun to see them getting the holistic care they need.

Brenda Kneeland,
EMCMHC CEO

EMCMHC’s first PACT team launched in March 2021, and it is currently serving 30 people from Miles City and the surrounding area. The team is fully staffed and includes a team lead, therapist, administrative assistant, medication management provider, care manager, paraprofessional, registered nurse, and two peer supporters. The second team launched out of Glasgow in June 2021. This team serves 26 people throughout the state’s northwest region, including Wolf Point, St. Marie, Nashua, Malta, Plentywood, and Culbertson. When fully up and running, each team will have the capacity to serve 50 people.

While there have certainly been challenges – including the long distances between towns, spotty internet coverage, recruiting qualified staff, and shifting the way the organization operates internally – early outcomes speak to the program’s promise.

So far, there haven’t been any new hospital admissions or incarcerations among PACT clients. PACT is allowing EMCMHC to become nimbler in its operations, create better community partnerships, and provide more effective, responsive care to people living across its vase frontier service area.

This is working because we have employees who really care about people and good community stakeholders. There are challenges, but in Eastern Montana, we are used to things being difficult. PACT is an extension of the Eastern Montana philosophy – our communities are extremely resilient, and we take care of each other. Failure isn’t an option.

Brenda Kneeland,
EMCMHC CEO

By bringing together teams of health professionals to provide high-level treatment and supportive services for people where they live, EMCMHC is helping people with mental illness live and thrive in Eastern Montana. While starting a new program that serves some of the most vulnerable people living across Montana’s broadest geographic area is daunting, EMCMHC faces the challenge head-on with positivity and enthusiasm born out of the knowledge that they’re making a difference.