Helping the Mentally Ill in Jails Adjust to Community Life: A Description of a Postrelease ACT Program and Its Clients

Abstract

More than 25 years ago, researchers noted that persons with serious mental illness (PSMIs) were being processed increasingly through the criminal justice system instead of through the mental health system. Nearly 1 of every 15 admissions, or approximately6% of jail detainees, suffers fromsevere mental disorders at the time of arrest. Many PSMIs in jail receive psychiatric services during their incarceration but are usually discharged with no referrals to community treatment and no income or housing. Such persons can be managed effectively with Assertive Community Treatment (ACT) models. Thresholds, a psychiatric rehabilitation center, has funded a 2-year ACT Demonstration Project for PSMIs involved in Cook County’s (Chicago) criminal justice system. The project’s basic goals are to reduce the numbers of rearrests, reincarcerations, and rehospitalizations among project participants. To achieve these goals, project staff assists PSMIs to obtain psychiatric treatment, health care, housing, benefits, and other social services.

Integrating into the Mental Health System from the Criminal Justice System: Jail Aftercare Services for Persons with a Severe Mental Illness

“…Originally a pilot project designed to show the efficacy of ACT in maintaining persons with lengthy histories of arrests and jail days in the community, "Thresholds' Jail Demonstration Linkage Project" eventually became-because of continued need and because of the program's early success-an agency-funded ACT program dedicated to this population (Lurigio, 2000;Psychiatric Services, 2001). Thresholds' Jail Linkage and Aftercare Teams, in effect, form two parts of an Assertive Community Treatment team.…”

Co-Occurring Mental Illness and Substance Abuse in the Criminal Justice System

“…The closing and downsizing of state psychiatric hospitals during the 1960s (deinstitutionalization) resulted in greater numbers of mentally ill persons residing in the community (Sigurdson, 2000;Whitmer, 1979). The development of communitybased treatment services intended to accompany deinstitutionalization, however, failed to materialize in a significant way, and this failure left many of the recently deinstitutionalized individuals without appropriate resources and services (Lurigio et al, 2000;Lurigio & Lewis, 1987;Sigurdson, 2000). Inevitably, the responsibility for responding to problems associated with this population fell to the police (Lamb & Weinberger, 1998;Shepard Engel & Silver, 2001) and the criminal justice system (Goldkamp & IronsGuynn, 2000).…”

“Alternative to Prison” Programs for the Mentally Ill Offender

“…Furthermore, programs such as Pathways to Housing, which are specifically designed to meet the needs of dually diagnosed individuals are also more likely to have success in assisting MIOs since substance abuse is pervasive among this population. In addition, the success of the delivery of integrated services for released MIOs through ACT has also been documented (Lurigio, Fallon, & Dincin, 2000).…”