CASES and DOHMH Co-Host Roundtable Discussion on Forensic Assertive Community Treatment

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On May 13th, CASES and the New York City Department of Health and Mental Hygiene (DOHMH) convened a roundtable discussion on the effectiveness of Assertive Community Treatment (ACT) for people with serious mental illness involved in the criminal justice system. The event brought together representatives from state and city mental health and criminal justice agencies, national experts and researchers, and CASES staff to examine research findings of the Forensic ACT model. The group also learned how CASES’ Nathaniel ACT program, an alternative-to-incarceration program for felony defendants, operates within the continuum of New York City services available to people with serious mental illness who are at risk of poor treatment outcomes, violence and involvement in the criminal justice system.

Participants in the symposium included national experts Dr. Henry Steadman, President of Policy Research Associates, and Dr. Robert Weisman, Associate Professor of Psychiatry at the University of Rochester. Also in attendance were representatives from the New York State Office of Mental Health, NYC Department of Health and Mental Hygiene, NYC Department of Correction, NYS Division of Criminal Justice Services, NYS Office of Probation and Correctional Alternatives, NYC Department of Probation, Council of State Governments Justice Center, the Mayor’s Office of the Criminal Justice Coordinator, Bellevue Hospital Forensic Services, Services for the UnderServed, Kirby and Manhattan Psychiatric Centers, and the Langeloth Foundation.

Trish Marsik, Assistant Commissioner of the Bureau of Mental Health at DOHMH, indicated that “community based services for people with mental illness involved in the criminal justice system is an increasing priority for DOHMH. This meeting is very timely and we are committed to the expansion of diversion programs.” Dr. Steadman, a national expert and researcher on the intersection of mental illness, co-occurring disorders and the criminal justice system stated that the “CASES Nathaniel ACT program is probably the only Medicaid reimbursable ACT diversion program in the country. Many of the ACT teams across the country that claim they are ACT should really be characterized as forensic intensive case management (FICM) programs because they do not contain the elements necessary for ACT fidelity.” Dr. Steadman also stressed that communities gain the biggest cost-savings from investment in diversion programs for felony defendants, like those served by the Nathaniel ACT program.

Another issue discussed was how individuals with mental illness tend to cycle between psychiatric hospitals and jail while awaiting trial, and the way in which CASES and Kirby Forensic Psychiatric Center have addressed this problem through a memorandum of understanding establishing appropriate diversion procedures. Other issues discussed included the high rate of Nathaniel ACT participant homelessness and the program’s staffing pattern, range and intensity of services, and outcomes.

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