Program planning and staff competencies for forensic assertive community treatment: ACT-eligible versus FACT-eligible...

Area of Science:

• Forensic mental health services
• Community-based psychiatric treatment
• Criminal justice mental health

Background:

• Assertive Community Treatment (ACT) is an evidence-based model for severe mental illness.
• Forensic Assertive Community Treatment (FACT) is an adaptation of ACT for individuals involved with the criminal justice system.
• Understanding differences between ACT and FACT consumers is crucial for effective service delivery.

Purpose of the Study:

• To compare demographic, clinical, and criminal justice characteristics of ACT- and FACT-eligible consumers.
• To identify differences that may necessitate modifications to the FACT model.
• To inform the adaptation of FACT services for diverse forensic populations.

Main Methods:

• Utilized linked, multisystem administrative data from King County, Washington.
• Compared characteristics of consumers eligible for ACT versus FACT services.
• Analyzed demographic, clinical, and criminal justice variables.

Main Results:

• FACT-eligible consumers were more likely to be male and persons of color.
• FACT consumers presented with more complex clinical profiles.
• A significant proportion of FACT consumers had histories of violent offenses or sex offenses.

Conclusions:

• Traditional ACT models often exclude individuals with personality disorders, violent histories, or sex offenses.
• FACT teams may have less discretion in client selection due to mandated treatment and mental health courts.
• Clinical interventions and service modifications are likely essential for FACT teams to effectively serve their population.