A 'Stay Out of Jail' Program for Individuals with Mental Illness


Jeremy Reed’s client isn’t where he said he would be.

Not five minutes before this became apparent, Reed had spoken to him on the phone while driving south toward downtown Phoenix.

“What’s up man, it’s Jeremy. … What’s up, what are you doing? … You’re on 24th Street and Van Buren? … Hey, do you mind if I come get you so I can take you in to see the nurse so you can get your injection? … All right.”

After a scan of the McDonald’s at the prearranged cross streets, it’s clear that Reed’s client was mistaken about his location, left the restaurant in a hurry or lied about being there in the first place. But for Reed’s purposes, it really doesn’t really matter. He just needs to find him.

Reed, a case manager at Community Bridges, is part of a 13-person team that provides what’s known as “assertive community treatment” to those with serious mental illness.

The outreach-centered programs have become an industry standard for treating those with persistent and severe mental illnesses such as schizophrenia, major depression, panic disorder and bipolar disorder.

Focus on Catalysts

Reed’s ACT team narrows its scope even further. He’s part of a forensic ACT team (FACT), which works with seriously mentally ill clients with recurring run-ins with police.

Prisons and jails around the country often operate as de facto mental-health facilities, treating a disproportionately high number of offenders with mental illnesses.

A 2006 U.S. Department of Justice report estimated that 56 percent of state prisoners, 45 percent of federal prisoners and 64 percent of jail inmates had a mental-health problem.

FACT teams, like those in Maricopa County, aim to halt the revolving door of incarceration and hospitalization by focusing on the catalysts.

“One of the first questions that I ask (potential clients) when I’m doing a screening is, ‘Why do you get incarcerated? Why do you have police interaction?’ ” said Liz DaCosta, clinical coordinator for Community Bridges’ FACT team.

A Volatile Mix

Often, she said, it’s a volatile mix of homelessness, mental illness, drugs and a will to survive.

“The outdoors becomes their home, and their behavior and the mental illness is a lot more apparent than someone who has an apartment,” she said.

The group operates on a 90/10 philosophy, DaCosta said. In the beginning, the team is doing about 90 percent of the heavy lifting and the client is partaking in about 10 percent.

But over time, she said, the clients realize the changes are benefiting their lives — there’s a roof over their head, food in the refrigerator and a bed to sleep in. Gradually, the life changes inspire the clients to do more on their own.

The Community Bridges’ FACT team began accepting clients in August, and it is one of eight ACT teams that will be added to Maricopa County’s previous roster of 15 in the next two years. It is the second FACT team in Maricopa County, joining the People of Color Network’s existing team. Each team caps at 100 clients.

The FACT team has so far accepted 60 clients, 11 of whom are still awaiting release from incarceration. The team works with the Maricopa County Sheriff’s Office when screening for potential patients.

Since its inception, the team has experienced an 85 percent success rate in preventing its 49 clients from returning to jail or prison.

Experts say assertive community treatment enhances the quality of life for those involved while stemming the high price tag of recidivism and hospitalization.

Although it’s too soon to gauge what effect the team will have on local taxpayer dollars, some reports from FACT teams throughout the country have indicated promising results.

Editors Note: For the full version of this story, which appeared in the Arizona Republic January 27, please click HERE.

Megan Cassidy is a reporter for the Arizona Republic. She was a 2013-2014 Reporting Fellow for the John Jay/Langeloth “Health Behind Bars” health and criminal justice journalism project. She welcomes comments from readers.

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