The New Orleans Forensic Aftercare Clinic: a seven year review of hospital discharged and jail diverted clients

Abstract

This paper provides a review of the Forensic Aftercare Clinic Conditional Release Program (FAC), which has been operating since December, 1995, in New Orleans, LA. The FAC is a community based program that provides clinical, rehabilitative, and supervisory services to individuals who have been found not guilty by reason of insanity or unrestorably incompetent to proceed and who have been discharged from inpatient settings or diverted from jail settings and placed on conditional release by district court orders. 119 clients participated in FAC over a 7 year period. Forty-one (34.4%) had their conditional release revoked. Of the total population, 12 (10.1%) were re-arrested on at least one charge, 3 (2.4%) were arrested on felony charges, and 9 (7.6%) on misdemeanors. Only two of these charges were violent, resulting in no significant harm to victims. Twenty (16.8%) were hospitalized at least once due to relapse. Clients diverted from jail to community settings did not differ significantly on most variables from clients who were discharged from long-term hospitalization. Data related to public safety and client diversion demonstrate that clients, when appropriate, can be safely diverted to the community in lieu of hospitalization. The number of statewide clients who have been discharged from the forensic hospital into the community has increased steadily from 13 in 1995 to 29 in 2002, and statewide diversion clients have steadily increased from 0 in 1992 to 20 in 2002. The increase in statewide diversion clients and forensic discharges over this 7 year period indicates that stakeholders see the viability of the program as an alternative to as well as a step-down from long-term forensic hospitalization.

Reconviction and revocation rates in Flanders after medium security treatment

“…Comparisons between international studies are however difficult due to differences in several core aspects, such as the definition of the population, follow-up periods, outcome measures, settings and legal regulations (Lund, Forsman, Anckarsäter, & Nilsson, 2012). With regard to differences in outcome measures, most international studies investigating recidivism used reconviction as outcome measure, while some studies used re-arrest (Bertman-Pate et al, 2004) or an even broader definition of recidivism such as re-admission in a forensic hospital or any police contact (Lee, 2003). The more stringent definitions will logically result in lower recidivism rates.…”

“…Literature demonstrates that revocations for rule violations are higher than revocations for acquisition of new criminal charges (Vitacco, Vauter, Erickson, & Ragatz, 2014;Wiederanders, 1992). Revocation rates of rule violations range from 5% to 49% (Bertman-Pate et al, 2004;Callahan & Silver, 1998;Green et al, 2014;Manguno-Mire, Coffman, DeLand, Thompson, & Myers, 2014;Vitacco et al, 2008;Vitacco et al, 2014;Wiederanders, Bromley, & Choate, 1997) over different follow-up periods ranging from 1.7 to 5.1 years.…”

What Factors Are Related to Success on Conditional Release/Discharge? Findings from the New Orleans Forensic Aftercare Clinic: 2002‐2013

“…When the original study by Bertman-Pate and colleagues (2004) was published, criminal defendants in Louisiana who were unrestorably incompetent and not in need of inpatient treatment could be released on probation under state supervision (La C.Cr.P. Art.…”

“…The majority of studies focus on the conditional release of NGRI acquittees (Callahan & Silver, 1998; Monson, Gunnin, Fogel, & Kyle, 2001; Parker 2004; Vitacco et al ., 2008, 2011, 2013), although Bertman-Pate and colleagues (2004) and Wilson and colleagues (1995) evaluated conditional release in a mixed sample of mentally disordered offenders.…”

Outcome of patients rehabilitated through a New Zealand forensic psychiatry service: a 7.5 year retrospective study

“…For instance, Wiederanders, Bromley, and Choate (1997) reported 'annualized' rates of violent recidivism amongst 'not guilty by reason of insanity' (NGRI) patients in the community in three U.S.A. states varying from 3.4 to 7.8%. More recently, Bertman-Pate et al (2004) found a 10% rate over a 22.6 month follow-up. Lee (2003) in an 11 year study found that successful community outcome was related to duration of previous inpatient treatment, with longer admissions associated with less violence.…”