Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112333

Gary S. Cuddeback, PhD¹, Piper S. Meyer, PhD², and Joseph P. Morrissey, PhD². (1) Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 101 Conner Drive, Suite 302, Chapel Hill, NC 27514, 919-966-0995, cuddeback@mail.schsr.unc.edu, (2) University of North Carolina at Chapel Hill, Cecil G. Sheps Center for Health Services Research, 725 Airport Road, CB#7590, Chapel Hill, NC 27599-7590

Purpose: Existing guidelines suggest communities should provide enough Assertive Community Treatment (ACT) teams to serve 20% of their populations of individuals with severe mental illness (SMI). These guidelines have not been empirically evaluated and no such guidelines exist for Forensic Assertive Community Treatment (FACT). Therefore, the validity of these guidelines for the purposes of planning, financing, and developing ACT and FACT teams is examined. Methods: Retrospective, administrative data from a large, urban county, were used to identify the number of persons with SMI who were ACT or FACT eligible. Three groups were identified: (1) hospital use only (ACT-eligible), (2) jail use only (FACT eligible), and (3) jail and hospital use (FACT-eligible, heavy users). Results: Of 13,332 individuals with SMI, a total of 19% (n = 2,592) were either ACT or FACT eligible; however, only 6% (n = 833) met ACT eligibility criteria. Nearly twice as many persons, approximately 12% (n = 1,563), met FACT eligibility criteria. The heaviest users (jail and hospital) made up 1.5% (n = 196) of the county's SMI population. Also, compared to the hospital-only group, the jail-only and jail/hospital groups had higher percentages of males, African Americans, and individuals with co-occurring mental health and substance abuse disorders. Conclusion: These results suggest the existing guidelines may overestimate the numbers of ACT teams communities need. Furthermore, these results suggest communities should develop enough ACT teams to serve approximately 6 – 8% of their SMI populations and may need twice as many FACT teams to serve their forensic SMI populations.

Learning Objectives:

• To examine existing guidelines about the number of Assertive Community Treatment and Forensic Assertive Community Treatment teams communities should plan, finance, and develop.

Keywords: Mental Health Services, Criminal Justice

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.