Brooklyn & Manhattan FACT

The Intervention: Forensic Assertive Community Treatment (FACT)

Who is Served: Men and women with current or recent involvement in the criminal justice system who have serious mental illness and continuous high service needs

The Challenge

Approximately 20% of inmates in jails and 15% of inmates in state prisons have a serious mental illness.1 It is estimated that 17% of inmates (15% of males and 31% of females) in New York City jails have symptoms of a serious mental illness.2 Mostly poor people of color, justice-involved people with mental illness often struggle with the burdens of homelessness and drug addiction, chronic physical health problems, and social isolation. While incarcerated, people with mental illness receive limited and often inappropriate psychiatric care. Moreover, they are frequently released without any plan for ongoing care in the community, leading to a revolving door of arrest, confinement, release, and rearrest.

The FACT Approach

Since 2003, CASES has operated the Nathaniel ACT program as a two-year alternative to incarceration (ATI). We have now established the only Forensic ACT (FACT) team and also the first team with citywide services in New York City, operating according to OMG-and DOHMH-established ACT standards. FACT combines the services of ACT with a more explicit approach to prevent criminal recidivism through criminal justice collaborations. FACT supports the NYC Department of Health and Mental Hygiene’s work to reduce the fragmentation and silos within and between the mental health, homeless service, and criminal justice systems. The CASES FACT team has developed a Cultural Competence Plan that will encompass the demographics of clients and their communities, which includes social, recreational, cultural, educational and spiritual resources and venues available to clients. The FACT team also enrolls all eligible clients into a health home, with a priority focus on clients who are enrolled in Health and Recovery Plans (HARP). There, clients are connected to care management services.

The Impact

CASES FACT team is modeled after the Nathaniel ACT program. Once FACT is launched we will assess its influence based on Nathaniel ACT standards.


1 Torrey, E.F., Zdanowicz, M.T., Kennard, A.D., Lamb, H.R., Eslinger, D., Blasotti, M.C., & Fuller, D.A. (2014, Apr. 8). The treatment of persons with mental illness in prisons and jails: a state survey. Arlington, VA: Treatment Advocacy Center. Retrieved from ^

2 The City of New York (2016). Preliminary fiscal 2016 mayor's management report. NYC: City of New York. Retrieved from ^