Launched in 2000, The Nathaniel Project was NYC's first alternative-to-incarceration program for felony offenders with serious and persistent mental illness. The program was named for a homeless man whose mental illness went untreated for fifteen years as he cycled in and out of the criminal justice system.

In June 2003, after demonstrating the ability to work with a mentally ill, court-involved population, CASES created an Assertive Community Treatment (ACT) team, licensed by the New York State Office of Mental Health (OMH). Assertive Community Treatment is an evidence-based team treatment approach designed to provide comprehensive, community-based psychiatric treatment, rehabilitation, and support to persons with serious and persistent mental illness. The Nathaniel ACT program enables men and women with serious and persistent mental illness to successfully transition from incarceration to live in the community. In pursuit of this goal, the ACT team helps individuals reduce dangerous behaviors and substance abuse, leading to reductions in inpatient psychiatric admissions and emergency room use, while also controlling mental health symptoms and providing housing stability.

The program has won three national awards - from psychiatrists (2002 Significant Achievement Award from the American Psychiatric Association), criminal justice stakeholders (2002 American Probation and Parole Association's President's Award) and county mental health directors (2002 Thomas M. Wernert Award for Innovation in Community Behavioral Healthcare). In 2006, CASES received the Harp Commitment Award from the Howie the Harp Peer Advocacy Center for adopting the use of peer specialists (individuals who themselves have successfully overcome mental health issues) to better serve ACT clients.

The ACT Team

CASES' ACT team is made up of clinicians who have training and experience in psychiatry, mental health, nursing, social work, substance abuse treatment, peer support, employment and criminal justice. Members of the team work closely together to provide individuals with an integrated array of treatment and supervision services.

The team provides services in the community rather than in an office setting, visiting consumers at home, where they work and in other settings. Services are available 24 hours day, 7 days a week, to support community reintegration, stability and recovery.

Screening and Advocacy

CASES screens defendants in jail, advocates for participation in the program with judges and prosecutors, supervises participants in the community, and reports to judges and prosecutors on consumer progress in treatment.

Referrals to Nathaniel ACT

Services

• Case management - comprehensive assessment, treatment planning, and continuous risk assessment and management.
• Clinical services - medication administration and management, weekly treatment groups, and integrated mental health and substance abuse treatment.
• Supported housing - CASES operates an apartment in Brooklyn that provides long-term housing for six chronically homeless people with severe mental illness enrolled in ATI programs. We also have five beds of transitional housing for use on a short-term basis. Nathaniel staff work with program residents during regular home visits to help them develop independent living skills and prepare them for transition to permanent housing placements. While in the program, clients contribute a portion of their income toward rent.
• Supported employment - an evidence-based practice that provides eligible Nathaniel ACT clients with direct placement in competitive, real-world jobs with accompanying on-site support services as needed to help individuals perform their duties. Unlike more traditional vocational approaches, supported employment programs use a rapid job search and placement approach to help consumers obtain jobs directly, rather than providing them with pre-employment vocational training or placement in non-competitive employment. Supported employment staff and clients identify individualized job placements based on consumer preferences, strengths, and work experiences.
• Other support services - help obtaining Medicaid, food stamps, public assistance, and Social Security benefits, and referrals to external education, job training, employment, and housing providers.