A Randomized Controlled Trial of the Rochester Forensic Assertive Community Treatment Model
Open accessAbstract
OBJECTIVE: Forensic assertive community treatment (FACT) is an adaptation of the assertive community treatment model and is designed to serve justice-involved adults with serious mental illness. This study compared the effectiveness of a standardized FACT model and enhanced treatment as usual in reducing jail and hospital use and in promoting engagement in outpatient mental health services. METHODS: Seventy adults with psychotic disorders who were arrested for misdemeanor crimes and who were eligible for conditional discharge were recruited from the Monroe County, New York, court system. Participants were randomly assigned to receive either FACT (N=35) or enhanced treatment as usual (N=35) for one year. Criminal justice and mental health service utilization outcomes were measured by using state and county databases. RESULTS: Forty-nine participants (70%) completed the full one-year intervention period. Nineteen (27%) were removed early by judicial order, one was removed by county health authorities, and one died of a medical illness. Intent-to-treat analysis for all 70 participants showed that those receiving the FACT intervention had fewer mean±SD convictions (.4±.7 versus .9±1.3, p=.023), fewer mean days in jail (21.5±25.9 versus 43.5±59.2, p=.025), fewer mean days in the hospital (4.4±15.1 versus 23.8±64.2, p=.025), and more mean days in outpatient mental health treatment (305.5±92.1 versus 169.4±139.6, p<.001) compared with participants who received treatment as usual. CONCLUSIONS: The Rochester FACT model was associated with fewer convictions for new crimes, less time in jail and hospitals, and more time in outpatient treatment among justice-involved adults with psychotic disorders compared with treatment as usual.
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In Monroe County, New York, FACT enrollees compared to usual treatment had significantly fewer convictions (0.4 ± 0.7 vs 0.9 ± 1.3, p = .023).
“FACT enrollees had significantly fewer convictions (0.4 ± 0.7 vs 0.9 ± 1.3, p = .023)”
From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [77]
FACT enrollees had significantly fewer days in jail (21.5 ± 25.9 vs 43.5 ± 59.2, p = .025).
“days in jail (21.5 ± 25.9 vs 43.5 ± 59.2, p = .025)”
From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [77]
FACT enrollees had more days in outpatient mental health treatment (305.5 ± 92.1 versus 169.4 ± 139.6, p < .001).
“more days in outpatient mental health treatment (305.5 ± 92.1 versus 169.4 ± 139.6, p < .001)”
From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [77]
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Community Interventions to Promote Mental Health and Social Equity
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- Authors
- Lamberti, J. S., Weisman, R. L., Cerulli, C., Williams, G. C., Jacobowitz, D. B., Mueser, K. T., Marks, P. D., Strawderman, R. L., Harrington, D., Lamberti, T. A., & Caine, E. D.
- Affiliations
- University of Rochester Medicine (US)
- ORCID
- Venue
- Psychiatric Services
- Published
- 2017-10-01
- Volume
- 68
- Issue
- 10
- Pages
- 1016-1024
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- PMC
- PMC7369621
- OpenAlex
- W2620557848
- Cited by
- 58
- References
- 50
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 15 · 2021: 8 · 2020: 8 · 2019: 5 · 2018: 2
- FWCI
- 5.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34MH078003)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- assertive community treatment, severe mental illness, psychosis, criminal justice involvement, psychiatric hospitalization, outpatient mental health services, conditional discharge, misdemeanor arrests, Rochester, New York
- MeSH terms
- Adult, Ambulatory Care, Community Mental Health Services, Female, Humans, Male, Middle Aged, New York, Outcome and Process Assessment, Health Care, Patient Acceptance of Health Care, Psychotic Disorders, Young Adult, Criminals
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