Forensic Assertive Community Treatment: An Emerging Model of Service Delivery

NCT01313052 | Completed Phase 3 DMC

• 1 other identifier: 5R34MH078003-03
• Study Type: interventional
• Target: 53
• Locations: 1 country
• Sites: 1

Brief Summary

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. 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. 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.

Conditions

Psychotic Disorders

Keywords

Psychotic; Criminal

Outcome Measures

Primary Outcomes (2)

• Jail Recidivism

  The study will measure number of arrests, number of incarcerations, and total number of jail and/or prison days in the time frame described above.

  For the one year subjects are in the study.

• Mental Health Service Utilization

  The study will measure number of hospitalizations, number of hospital days, number of emergency room visits, number of outpatient mental health visits as primary outcome measures, and treatment appointment adherence.

  For the one year subjects are in the study.

Study Arms (2)

Forensic Assertive Community Treatment (FACT)

EXPERIMENTAL

Individuals in this arm will receive the services of an Assertive Community Treatment team and close supervision of a judge trained in the FACT model.

Behavioral: Forensic Assertive Community Treatment (FACT)

Enhanced Treatment as Usual

ACTIVE COMPARATOR

Individuals in this arm of the study will receive an expedited appointment at a clinic specializing in the treatment of psychotic disorders. These individuals will receive the services of a therapist, psychiatrist, and case manager.

Behavioral: Enhanced Treatment as Usual

Interventions

Forensic Assertive Community Treatment (FACT) BEHAVIORAL

Individuals in this arm will receive the services of an Assertive Community Treatment team and close supervision of a judge trained in the FACT model.

Forensic Assertive Community Treatment (FACT)

Enhanced Treatment as Usual BEHAVIORAL

Individuals in this arm of the study will receive an expedited appointment at a clinic specializing in the treatment of psychotic disorders. These individuals will receive the services of a therapist, psychiatrist, and case manager.

Enhanced Treatment as Usual

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Individuals diagnosed with any psychotic disorder such as Schizophrenia, Schizoaffective Disorder, Bipolar Disorder with Psychotic Features, Depressive Disorder with Psychotic Features, and Psychotic Disorder, Not Otherwise Specified.
• Individuals currently facing misdemeanor or violation charges who have not yet been sentenced.

You may not qualify if:

• Individuals do not have or cannot be diagnosed with a psychotic disorder.
• Individuals currently facing felony charges
• Individuals currently involved in any type of legal leverage including probation, parole, drug or mental health court supervision, Assisted Outpatient Treatment, or Criminal Procedure Law status.

Sponsors & Collaborators

• University of Rochester: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

Monroe County Jail

Rochester, New York, 14614, United States

Location

Related Publications (3)

• Lamberti JS, Deem A, Weisman RL, LaDuke C. The role of probation in forensic assertive community treatment. Psychiatr Serv. 2011 Apr;62(4):418-21. doi: 10.1176/ps.62.4.pss6204_0418.

  PMID: 21459994 BACKGROUND

• Lamberti, J., & Weisman, R. (2010). Forensic assertive community treatment: Origins, current practice, and future directions. In H. Dlugacz (Ed.), Reentry Planning for Offenders With Mental Disorders (1 ed., Vol. 1, pp. 145-169). Kingston, NJ: Civic Research Institute.

  BACKGROUND

• Lamberti, JS. (2011). Legal Leverage in the Treatment of Adults With Severe Mental Illness, in Workplace Violence in Mental Health and General Health Care Settings. Pages 225 - 236. M. Privitera, editor. Jones and Bartlett, Pages 225-236.

  RESULT

MeSH Terms

Conditions

Psychotic Disorders; Mental Disorders

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders

Study Officials

• J Steven Lamberti, MD

  University of Rochester

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, Department of Psychiatry

Study Record Dates

• First Submitted: March 8, 2011
• First Posted: March 11, 2011
• Study Start: May 1, 2008
• Primary Completion: May 1, 2014
• Study Completion: May 1, 2014
• Last Updated: February 28, 2017

Record last verified: 2017-02

Locations

US (1)