I never met Barb Lontz but I owe her a great deal.
In her telling of The Origins of PACT, Dr. Mary Ann Test recalls her team discussing how “patients whom we “successfully” discharged and carefully linked with the existing aftercare services rotated back to the hospital within weeks or months, usually in a psychotic and disheveled state.” In response someone commented:
… “You know, the patients that Barb Lontz works with intensively don’t come back. Maybe we should all go out and do what Barb does.” Barb was an innovative and spirited social worker on the ward that, among other things, helped clients with discharge planning. Indeed, when time allowed her, Barb did far more than plan discharge. She drove patients to their new residence in the community and then spent countless hours and days providing them with “hands on” support and assistance to help them live in the community. Barb helped clients move in and get sheets on the bed and a telephone installed; she taught clients how to use the local laundromat by doing laundry with them again and again. She instructed them to ride the bus to the mental health center to get medications by going side by side with them as many times as was needed. She worked next to her clients at the sheltered workshop until they felt comfortable. Barb telephoned clients often to problem solve and provide emotional support; she gave clients and their family and/or landperson her home telephone number to call evenings or weekends if a crisis arose. If there was an emergency, she drove out and intervened. As we listed the clients with whom Barb had worked intensively and continuously in this fashion, it was indeed apparent that almost none of them had come back to the hospital!”
It seems if it weren’t for Barb Lontz I wouldn’t have had 10 wonderful years of PACT work.
The attached Word file The Origins of PACT (click to download and view) has the full text as the original but with some in bold of my choosing – wanted to emphasize certain points. I use this document as an educational reading with my team and in resident teaching; I make folks read it out loud, otherwise RCTs have shown that 73% of the copies given out will be placed on the giant pile of papers we all mean to read ‘when we have the time’.
You’ll find Mary Ann Test’s original version on the ACTA website .
It’s good to know a bit of history if only to remind ourselves how far we’ve come and, more importantly, how far clients and their families have come while always remembering there is still a ways to go.
Shalom Coodin MD FRCPC