Adult Criminal Justice/Mental Health Interfaces – Morrissey, Cuellar
In earlier eras, public mental hospitals served as institutions of last resort
for care and confinement of individuals with mental illness. With the disappearance
of these institutions, jails have inappropriately become the last secure environment
for difficult-to-manage and noncompliant behavior. Today, about 500,000 people
with severe mental illness are annually detained in jails. Jail diversion programs
have been developed to avoid this problem by diverting mentally ill offenders
to treatment programs in their community. Diversion can occur at the time of
initial contact with a law enforcement officer (e.g., a pre-booking situation
where a person with severe mental illness never makes it to the jail) or after
booking. In the latter case, a sentence may be shortened, postponed, or deferred,
as long as treatment is received. Programs have been growing steadily, with at
least 300 jail diversion programs nationwide. But results have been mixed. One
possibility is that the treatment to which they have been diverted is not the
best available care. In response, one of the evidence-based practices for persons
with severe mental illness, Assertive Community Treatment (ACT), is being extended
and adapted for mentally ill offenders. ACT is an intensive treatment given by
a team of professionals, each member bringing special skills in psychiatry, drug
abuse, counseling, or other specialties. But little information exists about
these so-called Forensic Assertive Community Treatment (FACT) teams, or their
effectiveness at improving both mental health and criminal justice outcomes.
This Network project profiles the variety and core attributes of FACT teams based
on a telephone survey and on site visits around the country; it brings together
several FACT-team leaders and researchers to determine the teams’ core attributes;
and it asks whether these programs are cost-effective by conducting a meta-analysis
of data collected by several jail diversion sites in California.
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Last modified: June 1, 2006
©2006 MacArthur Foundation Network on Mental Health Policy Research
Last Revised: June 2006