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Outcomes of assertive community treatment in an NGRI conditional release program
1Indiana University School of Medicine, Indianapolis, IN, USA. geoparke@iupui.edu
The Journal of the American Academy of Psychiatry and the Law
|November 2, 2004
Summary
Assertive community treatment (ACT) for individuals found not guilty by reason of insanity (NGRI) on conditional release (CR) resulted in good community tenure, with low arrest rates and moderate hospitalization rates over five years.
Area of Science:
- Forensic Psychiatry
- Mental Health Services Research
- Criminal Justice and Mental Health
Background:
- Individuals found not guilty by reason of insanity (NGRI) often require ongoing community supervision.
- Conditional release (CR) programs aim to balance public safety with patient reintegration.
- Assertive community treatment (ACT) models are intensive, community-based interventions.
Purpose of the Study:
- To evaluate the five-year outcomes of an ACT program for NGRI acquittees on CR.
- To determine the rates of arrest and hospitalization within this population.
- To identify predictors of community tenure, arrest, and hospitalization.
Main Methods:
- Retrospective review of court reports and state computer databases.
- Analysis of data from 83 NGRI acquittees participating in an ACT program.
- Multivariate logistic regression to identify predictive factors.
Main Results:
- The study monitored 83 NGRI acquittees over five years.
- Overall community tenure was 83% of eligible CR time.
- There were 5 arrests and 60 hospitalizations; estimated annual arrest rate was 1.4%, hospitalization rate was 14.0%.
Conclusions:
- The ACT model demonstrated effectiveness in managing NGRI acquittees on CR.
- Longer duration of CR predicted better outcomes.
- Paranoid schizophrenia was associated with increased risk of hospitalization or arrest.