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Chapter 12 - Forensic Assertive Community Treatment

An Emerging Best Practice

from Part I - Neuroscience

Published online by Cambridge University Press:  29 April 2026

Katherine Warburton
Affiliation:
California Department of State Hospitals, University of California, Davis, USA
Stephen M. Stahl
Affiliation:
University of California, Riverside, USA
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Summary

People with serious mental illness (SMI) are over-represented throughout the US criminaljustice 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.

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