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Essential Elements of Forensic Assertive Community Treatment.

J Steven Lamberti1, Robert L Weisman

  • 1From the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY.

Harvard Review of Psychiatry
|May 25, 2021
PubMed
Summary
This summary is machine-generated.

Forensic Assertive Community Treatment (FACT) programs require high-fidelity adaptation of the Assertive Community Treatment (ACT) model. Essential elements include integrated mental health and criminal justice criteria, collaboration with justice agencies, and risk/need assessment for effective treatment.

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Area of Science:

  • Forensic Psychiatry
  • Mental Health Services
  • Criminal Justice Interventions

Background:

  • Forensic Assertive Community Treatment (FACT) is an international intervention for individuals with serious mental disorders involved in the criminal justice system.
  • Existing FACT programs exhibit significant variability in design and operation.
  • There is a need to define essential elements for effective FACT program implementation.

Purpose of the Study:

  • To present a perspective on the essential components of Forensic Assertive Community Treatment (FACT) programs.
  • To provide recommendations for optimizing FACT program design and operation based on literature review and experience.
  • To introduce a fidelity scale for measuring FACT program adherence.

Main Methods:

  • Literature review and synthesis of relevant experience.
  • Identification and discussion of essential FACT program elements.
  • Development and introduction of the Rochester Forensic Assertive Community Treatment Scale (R-FACTS).

Main Results:

  • FACT programs should maintain high-fidelity Assertive Community Treatment (ACT) components.
  • Integrated mental health and criminal justice admission criteria are crucial.
  • Effective FACT requires collaboration between mental health clinicians and criminal justice agencies, risk/need assessment, and evidence-based practices.
  • Additional considerations include housing, medical care, and transitional services.

Conclusions:

  • The Rochester Forensic Assertive Community Treatment Scale (R-FACTS) operationalizes essential FACT elements.
  • The R-FACTS aims to support consistent and measurable FACT program development, implementation, and dissemination.
  • Standardizing FACT programs can enhance their effectiveness in serving individuals with serious mental disorders within the criminal justice system.