Persons with mental illnesses who are released from jail or prison are at high risk of psychiatric decompensation and re-arrest. This paper describes an ACT jail linkage program for this population that won an American Psychiatric Association Gold Award (2001). Based on interviews with its first 24 participants, we illustrate how they experience factors that contribute to recidivism and decompensation. Pre- and post-data are examined to explore program outcomes. Results suggest that it is possible to identify, engage, and retain people in treatment who struggle with many risk factors. We conclude that this program should be expanded and replicated.

Mothers with mental illnesses, who are homeless, as well as their children, are highly vulnerable and need specialized services. This retrospective study describes the experience of the Thresholds Mothers' Project in serving 24 homeless mothers. Benchmarks suggest that the mothers and their children benefited from the program. A year after intake, 79% were still engaged in services and were all living in either independent apartments or in supportive housing. The majority of the children in their mother's care at intake were still living with them 1 year later, 77%. The Mothers' Project provides an exemplary model of how to serve this vulnerable population.

This retrospective study examines 18-month outcomes for 38 participants in an urban, residential integrated treatment (IT) program, and whether residents experienced different treatment benefits. Informed by an ACT team approach, the program emphasized harm reduction and motivational interventions. The design is naturalistic, and outcomes are self-comparisons over time reported in the aggregate. Repeated measurements with three standardized scales tracked stage of treatment and extent of alcohol and drug use. Outcomes analyses reveal advancements in stage of treatment and significant reductions in use of alcohol and drugs. Participants also worked more and were hospitalized less.

This study presents findings from a 21-month study situated at a large PSR agency (Thresholds). Comparisons of vocational outcomes are reported for two groups of people who are members of an Assertive Community Treatment [ACT] program. A comparison group (n = 144) received routine ACT services. The intervention group (n = 139) received ACT and vocational services through a "blended vocational model," combining elements of the agency's extant Diversified Placement Approach with elements of the Individual Placement and Support model. The positive outcomes demonstrate that combining elements of both models is a valuable option for psychiatric rehabilitation agencies to consider.

The hypothesis that second-generation antipsychotics promote better employment outcomes than first-generation antipsychotics was not upheld. However, second-generation agents appear to be associated with increased participation in vocational rehabilitation.