Psychotic Disorders Clinical Trial
Official title:
Forensic Assertive Community Treatment: An Emerging Model of Service Delivery
The FACT model (ACT + legal leverage in the form of judicial monitoring) will be compared to
enhanced outpatient treatment (close outpatient follow-up without judicial monitoring).
Seventy adults with psychotic disorders in Monroe County who are convicted of a misdemeanor
will be randomly assigned to each treatment group and followed for 12 months. Primary
outcomes will include criminal justice and mental health service utilization rates,
treatment adherence, psychiatric symptoms, substance abuse, homelessness, perceived
coercion, and consumer satisfaction. Service utilization outcomes will be tracked using
established mental health and criminal justice databases.
Hypotheses are:
1. FACT (ACT plus judicial monitoring) will have a greater effect than enhanced TAU in
promoting treatment adherence among high-risk adults with psychotic disorders.
2. FACT (ACT plus judicial monitoring) will have a greater effect than enhanced TAU in
preventing arrest, incarceration, emergency department and inpatient hospital use among
high-risk adults with psychotic disorders.
FACT (Forensic Assertive Community Treatment) is an adaptation of the Assertive Community
Treatment (ACT) model that addresses a significant gap in our service delivery systems by
targeting the interface between mental health and criminal justice services. ACT was
originally developed to engage severely mentally ill adults in outpatient psychiatric
treatment through the use of assertive outreach and comprehensive services. FACT adds legal
leverage in the form of judicial monitoring to ACT, which is comprehensive, high intensity,
mobile, psychiatric treatment.
The FACT model (ACT + legal leverage in the form of judicial monitoring) will be compared to
enhanced outpatient treatment (close outpatient follow-up without judicial monitoring).
Seventy adults with psychotic disorders in Monroe County who are convicted of a misdemeanor
will be randomly assigned to each treatment group and followed for 12 months. Primary
outcomes will include criminal justice and mental health service utilization rates,
treatment adherence, psychiatric symptoms, substance abuse, and homelessness. Service
utilization outcomes will be tracked using established mental health and criminal justice
databases.
Hypotheses are:
1. FACT (ACT plus judicial monitoring) will have a greater effect than enhanced TAU in
promoting treatment adherence among high-risk adults with psychotic disorders.
2. FACT (ACT plus judicial monitoring) will have a greater effect than enhanced TAU in
preventing arrest, incarceration, emergency department and inpatient hospital use among
high-risk adults with psychotic disorders.
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