Lamberti J Steven, Weisman Robert L
Chair, Research Subject Review Board for Behavioral and Social Sciences, Professor of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
Director, Charles E. Steinberg Memorial Fellowship in Psychiatry and Law, Professor of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
CNS Spectr. 2025 Feb 20;30(1):e34. doi: 10.1017/S1092852925000069.
People with serious mental illness (SMI) are over-represented throughout the US criminal justice system. To address this issue, forensic assertive community treatment has recently emerged as a best-practice intervention. Also known as forensic ACT, ForACT, or most commonly as "FACT," forensic assertive community treatment is an adaptation of the assertive community treatment (ACT) model. Unlike ACT, however, FACT is purposefully designed to prevent arrest and incarceration among people with SMI who have histories of involvement with the criminal justice system (i.e., "justice-involved" individuals). Although FACT was recognized as a best practice by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2019, FACT teams vary widely in their structure and daily operations. This lack of a standard FACT model continues to impede FACT program implementation and outcomes research. This article begins with a review of FACT origins, followed by a discussion of what we know (and do not know) about FACT operation and effectiveness. Based on the authors' experience, the article then discusses key components of FACT and concludes with a discussion of current challenges and research recommendations for FACT model development.
在美国整个刑事司法系统中，患有严重精神疾病（SMI）的人所占比例过高。为解决这一问题，法医积极社区治疗最近已成为一种最佳实践干预措施。法医积极社区治疗也被称为法医ACT、ForACT，或最常用的“FACT”，它是积极社区治疗（ACT）模式的一种改编形式。然而，与ACT不同的是，FACT是专门为防止有刑事司法系统介入历史的严重精神疾病患者（即“涉及司法”的个人）被捕和监禁而设计的。尽管FACT在2019年被药物滥用和心理健康服务管理局（SAMHSA）认定为最佳实践，但FACT团队在结构和日常运作方面差异很大。缺乏标准的FACT模式继续阻碍FACT项目的实施和结果研究。本文首先回顾FACT的起源，接着讨论我们对FACT运作和有效性的了解（以及不了解的方面）。基于作者的经验，本文随后讨论FACT的关键组成部分，并以对FACT模式发展的当前挑战和研究建议的讨论作为结尾。
