Adapting ACT for jail diversion: current evidence and needed research

Abstract

Results In one review [1], 7 of 10 randomized trials found that ACT was no more effective in reducing arrests and jail stays than usual care and in one trial it was less effective. Another recent trial [2] found that receipt of ACT was not a significant predictor of a range of criminal justice outcomes including offenses, arrests, incarcerations, or court summons. Current FACT programs strip away some highfidelity components of ACT (such as 24 h availability, daily team meetings, an employment specialist) and add new elements not found in typical ACT teams (such as a probation or parole officer on the team, recruitment from criminal justice settings, supervised residential treatment component for high risk consumers with substance abuse comorbidities.) Current evidence for the effectiveness of these FACT models is sparse. Some uncontrolled studies suggest positive effects, but the one randomized trial reported to date found no differences between a FACT-like intervention and usual care. Conclusion ACT alone or its FACT adaptations do not appear to be able to keep mentally ill offenders out of jail. Interventions are also needed that target criminal behavior and life-styles. Further research on the effectiveness of these FACT-plus models can grow the evidence base for how to reduce the criminalization of mental illness.