Abstract

Abstract A unique public-private partnership created a new continuum of care that would effectively bridge the gap between inpatient treatment and community after-care for insanity acquitees suffering from chronic mental illness and substance abuse disorders. Focusing specifically on the needs of dually-diagnosed patients, treatment is delivered in a secure, 42-bed residential facility using a carefully designed series of hierarchical stages that enable residents to gradually build and strengthen their coping and life skills. Following graduation from the residential program, patients receive “assertive community treatment,” which provides enhanced, enduring supports to prevent “revolving door” recidivism. Although the patients have severe chronic diagnoses and have been acquitted of extremely dangerous criminal behavior, eighteen discharged patients have made a successful transition to the community for an average of 508 days without a single relapse into criminal behavior or substance abuse. Only two have required brief temporary readmission for stabilization of mental illness, and one needed inpatient readmission.

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