Assertive Community Treatment and the Mentally Ill Offender

1
Assertive Community Treatment and the Mentally
Ill Offender

• An Investigation Into the Relationships Between
  Program Structural Features and Outcome Measures
  of Mentally Ill Offenders

2
Structural Facets of Eight Factor Model
Team Intensity

• Contact Frequency
• Team Meeting
• Team Approach
• Service Intensity
• Small Caseload

3
Structural Facets of Eight Factor Model
Community Treatment

• In-Vivo Services
• Hospital Admissions Responsibility
• Treatment Responsibility
• Admissions Criteria
• Crisis Services
• Work With Supports

4
Structural Facets of Eight Factor Model
Engagement/Retention

• No-Drop Policy
• Assertive Engagement
• Hospital Discharge Planning
• Time-Unlimited Service

5
Structural Facets of Eight Factor Model
Substance Abuse Treatment

• Substance Abuse Groups
• Substance Abuse Treatment
• Dual-Disorder Model

6
Structural Facets of Eight Factor Model
Specialist Staffing

• Substance Abuse Specialist
• Nurse on Staff
• Psychiatrist on Staff
• Vocational Specialist

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Structural Facets of Eight Factor Model
Caseload Distribution

• Team Leader Role
• Intake Rate

Staff Capacity and Continuity

• Staff Capacity
• Continuity of Staffing

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Methods of Analysis
Logistic Regression

• Establish a relationship between an outcome and a
  set of predictors
• If one is found, simplify the model by
  eliminating some of the predictors while still
  maintaining strong prediction or explanatory
  power
• Dichotomize dependent variable into two groups
  coded 0 1
• Examine strength of association
• Examine the effect of the change of each
  predictor on the odds of being in one group or
  the other

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Outcome Measures
Dichotomized Criminal Engagement Index

• Number of bookings
• Number of convictions
• Number of days in jail
• Group 0 no criminal involvement
• Group 1 any degree of criminal involvement

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Outcome Measures
Dichotomized Quality of Life Index

• First Eschelon of Quality of Life
• Type of Employment
• Living Arrangements
• Group 0 Unfavorable Life Situation
• Not in the paid work force
• Homeless or in intensive care
• Group 1 Favorable Life Situation
• Paid work force
• Group or independent living
• Second Eschelon of Quality of Life
• Non-Employment Sources of Income

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ACTness and Criminal Engagement
Model 1
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ACTness and Criminal Engagement
Model 2
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ACTness and Criminal Engagement
Relative Importance of ACT Facets

• Substance Abuse Treatment (.255)
• Specialized Staffing (.250)
• Caseload Distribution (.204)
• Team Intensity (.176)
• Community Treatment (.097)
• Staff Capacity Continuity (-.100)
• Engagement Retention (n.s)

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ACTness and Quality of Life Index
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ACTness and Quality of Life Index
Relative Importance of ACT Facets

• Caseload Distribution (.334)
• Team Intensity (.324)
• Engagement Retention (.308)
• Community Treatment (.246)
• Specialist Staffing (.216)
• Staff Capacity Continuity (.000)

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QUESTIONS?