In FY13-14, the program achieved the following:
Targeting Extremely Complex, Longer-Term Needs
"This type of ACT program is really designed for people who don't do well in other settings," said Debra Evans, administrator of SB FACT.
"They may have really disruptive behaviors or they may disengage and not participate in other program settings. They may be medically compromised and be going in and out of the hospital for physical health issues like diabetes.
"They have a lot of substance issues and are usually very high users of crisis services and acute hospitals," said Debra. "We also take people who are not able to really use other services in the County. They may be having trouble with the existing day treatment approach and struggle to get to groups five days a week. Or, they may just need services longer than other programs are able to provide."
"The people we work best with are the ones with the most complex needs. We go to them. We meet them wherever they are," she says.
Will Prop 47 be helpful to the people served by SB FACT?
"Yes, absolutely," said Debra. "The people we serve come in with a lot of substance use charges. They're stealing to survive. They are folks who aren't feeling centered. They can be really paranoid or psychotic in the community. The right supports makes a difference. And Prop 47 will give a lot of people a chance to clear their records. A felony record makes life a lot harder. This will help them open up new opportunities."
The ACT model is extremely helpful in serving people with SMI and justice involvement. The ability to be out in the field, in real-life environments, is extremely helpful in working through the challenges and changes that make recidivism more likely.
ACT Model with Key Differences
- Staff-to-member ratio of 1:10
- 75% of services delivered in the field
- Multidisciplinary team including:
- A full-time psychiatrist who delivers services in the field
- A full-time probation officer on the team that helps ensure coordination and collaboration be tween the client, the team, the mental health department, and the criminal justice system.
Partnering with Mental Health Courts and Jails
- All referrals come from the mental health courts in collaboration with the county behavioral health department.
- The SB FACT treatment team helps ensure that clients adhere to the high standards of the mental health court by being actively involved with the client in discussing and understanding court requirements, participation, and the consequences of re-offenses or relapses.
- When members do end up back in jail, the program coordinates with the jail to ensure continuity of care, even though the member is incarcerated.
Addressing the Whole Person as Much as Possible
- Physical health: The program helps clients to track their own health needs and become better at proactively managing issues and preventing emergency care. The program also maintains close coordination with numerous medical centers to help clients use medical care in the most appropriate, organized, efficient ways possible.
- Substance use: Almost all members of SB FACT have substance use issues. The program also coordinates with specialized substance programs whenclients need higher levels of care or more intensive rehab services.
- Housing: The program maintains relationships with housing facilities at all levels of the care spectrum. This includes options such as sober living, board and care, etc.
Working with Members
"I think one of the things that makes this program effective is the way we work with people... our recovery approach," said Debra. "We work really hard to create an environment where people feel like they have support, like they belong," she says. "Clients come to this program and they say, 'You don't treat us like criminals.'"
"Even though our members have criminal justice backgrounds, we always try to work from a place of advocacy. Just because someone comes up positive when we drug test them doesn't mean that's the whole story. Sometimes hard things happen. You don't know until you ask that a member may have lost their brother and relapsed as a result."
Working with the Courts
"Yes, we need to report people to the courts and their PO, but we also try to listen and understand. We take a harm reduction approach. We are collaborative versus punitive. We work to make sure the courts know the bigger story, and then we help clients get through these things and learn from the process, so that next time challenges come up, they can get through it a little easier with less harmful consequence."