Each year in Manhattan an average of 100,000 offenders are processed during six shifts of arraignments per day. Although arraignments is the last opportunity a mentally ill offender has to be assessed for mental health treatment needs before being sent to jail, at Manhattan's arraignment parts, there is no one present to perform this assessment. The Nathaniel Project's EXIT Program fills that service gap by intercepting the flow of offenders at arraignments, assessing the needs of mentally ill offenders, and advocating for their diversion from the court system. In doing so, the Program reaches out to - and envelops in New York City's service network - people with mental illness who had previously slipped through that network's cracks.

The EXIT Program serves individuals with mental illness being adjudicated on a non-violent misdemeanor offense and who require ongoing psychiatric treatment and support to function in the community. Eligible individuals are sentenced to an Adjournment in Contemplation of Dismissal and mandated to participate in a treatment assessment session at CASES with the option to voluntarily continue case management and engagement in services for a six-month period.

Referral & Eligibility
The EXIT Program's Forensic Clinical Coordinators work with defense attorneys, prosecutors and judges to encourage referrals to the Program. To be eligible, an individual must:

- Be appearing in Manhattan's Criminal Court Arraignment Part on a
  non-violent misdemeanor charge;
- Be facing five to thirty days in jail;
- Have three or more prior convictions;
- Have indications of a DSM-IV Axis I diagnosis (meeting New York
  State criteria for a severe and persistent mental illness);
- Be motivated to engage in treatment.

Mandatory Treatment Assessment Session
The cornerstone of the EXIT Program is the treatment assessment session. During the critical first hours of contact, the focus of the session is the engagement of the participant in the possibility of treatment and in beginning the process of jointly formulating a community living plan. This marks the beginning of a collaboration between the Clinical Coordinator and the participant. The community living plan addresses the client's preferences and needs for mental health and substance abuse treatment, in housing, medication and other medical care, public benefits and Medicaid, social and familial supports, and any other required services. The goal of this intervention is to help the participant identify issues and areas that he or she perceives as important for engaging in treatment and preventing further involvement with the criminal justice system. The participant and his or her Clinical Coordinator identify which behaviors and symptoms are most related to re-arrest, review the services the program is able to provide, and identify the expectations the program has of the participant as well as the expectations the participant has of the program. While the session addresses any immediate needs that the participant may have, the ultimate goal of the intervention is to help participants accept the possibility that treatment could work.

Voluntary Six-Month Intensive Case Management
During the six-month period of voluntary case management staff work intensively with participants, providing logistical and emotional support as they access entitlements and critical services. For seriously mentally ill individuals, the opportunity to form a supportive ongoing therapeutic relationship is the foundation for subsequent recovery and independence. By building trusting relationships with Program staff, participants are better able to accept help from other providers. In this way, participants who have not previously succeeded in treatment move toward psychiatric stability and recovery and engage in the services they need to live safely and as independently as possible in the community.