Forensic Assertive Community Treatment: Demographic and Clinical Characteristics of Jail Diversion and Prison Reentry Consumers

Persons with mental illness who are involved with the criminal justice system are one of the most pressing public health and public safety challenges facing most communities today. Forensic assertive community treatment (FACT) teams for jail diversion and prison reentry have developed rapidly; however, more information is needed about the demographic and clinical differences between jail and prison offenders with severe mental illness and how these differences might present challenges for FACT teams. Here, the demographic and clinical characteristics of 212 jail diversion FACT consumers and 198 prison reentry FACT consumers were examined. Compared to jail diversion consumers, prison reentry consumers were more likely to be male (p < .05), have schizophrenia (p < .001), and were older (p < .01). Jail diversion consumers were more likely to be female (p < .05), have mood disorders (p < .001) and have co-occurring substance use disorders (p < .001). Both diversion and reentry consumers had high rates of physical health problems and treatment non-compliance, and histories of suicide attempts, sexual abuse, interpersonal violence, and homelessness. The integration of physical health care is particularly important for FACT and FACT teams need an array of strategies to foster engagement and compliance. Adding clinical interventions, such as integrated dual disorder treatment, trauma-informed services, and interventions to address interpersonal violence, could be particularly important for FACT teams. This study contributes to the growing literature about FACT and provides important information for communities that are planning FACT teams for jail diversion or community reentry.