Kandiyohi, Meeker, Renville, and Yellow Medicine Counties, Minnesota

Initial Funding:

October 1999


PACT 4’s mission is to provide an array of services for children and their families in an individualized and sensitive style, capitalizing on the strengths and expertise of families, communities, and youth-serving agencies. PACT 4 is dedicated to the principle that prevention and early intervention work best for children, families, and the entire community. A principal goal of the CMHS-funded PACT 4 is to demonstrate that a large rural agricultural area, undergoing rapid demographic and economic upheaval, can accomplish widespread systems change to improve the lives of families with children with serious emotional disturbance. Specific PACT 4 goals include the following: Create a family-driven system of care responsive to the individual needs of each family; Establish culturally competent services that operate within a system-wide set of congruent behaviors, attitudes, and policies; Grow and sustain parent leaders; Nurture an informal support system based on the traditional community roots in this rural region that will encourage families and reduce their inherent isolation; Strengthen the clinical competency of the system through training on best practices and through implementing cross-agency responses; Design relevant outcome-based research to ensure continued quality improvement; Be held accountable by its community to the very community-based standards it creates.


PACT-4 is located in west central Minnesota, in an area 100 miles west of Minneapolis–St. Paul extending to the South Dakota border. The four counties participating in PACT-4 cover 3,150 square miles and together have a population of 91,881, based on the 2003 Census estimate. According to the United States Census from 2000, in addition to a majority population base of European-Americans, PACT-4’s service area includes 4,853 Latinos, 492 Indigenous Americans, and 302 Asians. In addition, there are an estimated 400 members of the Somali and Ethiopian communities. A small number of African-American and Asian-American children have been adopted by White families in the catchment area, according to PACT-4 program statistics. The 1990 census figures combined with SAMHSA’s 10 percent prevalence estimate led to the determination, at the time of the grant proposal, that approximately 2,731 children in the PACT-4 service area were experiencing serious emotional disturbances. As of December 2004, PACT-4 had served a total of 331 children; 222 (67 percent) were male and 109 were female. Of these, 284 (86 percent) were White, 47 (14 percent) Hispanic origin, 12 African-American, 10 American Indian, 6 Other, and 8 Unknown. PACT-4’s target population includes children aged birth to 21 who have a DSM–IV diagnosis and who meet one of the guidelines for serious emotional disturbance in the State of Minnesota. These guidelines include: The child has been admitted in the last 3 years, or is at risk of being admitted to inpatient treatment or residential treatment for an emotional disturbance; The child is receiving treatment for an emotional disorder through the interstate compact; The child has one of the following, as determined by a mental health professional: psychosis or clinical depression; risk of harming self or others; or symptoms as a result of being a victim of physical abuse, sexual abuse, or psychic trauma within the past year; The child, as determined by a mental health professional, has significantly impaired home, school, or community functioning that has lasted 1 year or is at risk of lasting 1 year.


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