Community Support Programs in Dane County

By: Ron Diamond, Board Member

When I was a Psychiatry resident in California in 1974, I was taught that people with schizophrenia could not be treated in the community. At the time this was largely
true. This was a time in which there was no idea of providing outreach to people
living in the community, any idea of providing help with practical issues making
sure that people had housing and food, and no response if someone failed to keep an
appointment. Then along came Len Stein, Mary Ann Test and Arnie Marx, working
out of the research unit of Mendota Mental Health Institute, who thought about the
problem from an entirely different perspective. They asked what would be needed
to support people with schizophrenia who were living in the community, people
who may not always make appointments and who may need help the concrete
issues of living day to day. This group started the first assertive outreach team,
called ACT or PACT in other parts of the country but called CSP, Community Support
Teams, in Wisconsin.

This has grown from a single research team in Madison to teams that now exist
around the world, from Europe to Japan and in most of the states in the U.S. Along
the way these teams have been researched and improved, there are now fidelity
measures to allow one to determine if team calling itself a CSP or an ACT teams
really implements those elements that make it effective, and the idea of these teams
has been extended to allow them to be effective with different populations. There is
now extensive research demonstrating that these teams are both clinically effective
and cost effective in helping people with schizophrenia be more stable and have a
higher quality of life than without the teams.

There are currently 4 CSP teams operating in Dane County, depending a bit on how
one counts. Journey Mental Health operates three teams, Gateway CSP, Forward
Solutions CSP, and Community Treatment Alternatives (CTA). CTA was specifically
set up to work with people with psychotic disorders who have been involved in the
criminal justice system, and most of the consumers in this team are either referred
while they are in jail or as part of a conditional release program. The VA also
operates its own CSP program, and PACT, the original program that started in the
1970s as a research program continues to operate under the auspices of the MMHI.

There are a number of programs in Dane County that include some of the elements
of a CSP, including PROPS (Promoting Recovery from Onset of Psychosis), a program
of Journey Mental Health Center, includes many of the elements of a CSP program, as
does CCS (Comprehensive Community Services), programs operated both by a
number of providers, including Journey Mental Health