Forensic and Mental Health Services, Inc.

851 Walnut Street
Hamilton, OH 45011
513-867-5866

Project Title
Butler County ACT Team
Grant Description
To establish an ACT Team for people with severe mental illnesses involved in the criminal justice system in Butler County
Focus Area
Joint Substance Use Disorders/Severe Mental Illness
Region Served
Butler County, OH
Award Amount
$200,000
Year Awarded
2004
Grant Duration
24 months
Results
 Staff were hired and trained for an ACT team; procedures and protocols were developed; meetings were held and updates provided to the Mental Health Board; and regular meetings were held with the Probate Court.  Involving a psychiatrist in the Act Team was somewhat problematic for two primary reasons: lack of initiative taken by the initial team leader to schedule the psychiatrist into the team and turnover in the psychiatrist position.  As a result, rather than have one doctor involved with the team, several psychiatrists work with the team.

Their were over 30 ACT cases in the first year; the ACT Team had a caseload of 66 people in the second year and 85% of the services were provided in the community.

Forensic and Mental Health Services conducted a program evaluation. The outcomes are:

  • 5% decrease in the number of bed days used annually at Summit (The data collected for this outcome were bed days for all clients of Forensic and Mental Health Services.  In retrospect, the impact of the ACT Team on hospitalization should have been measured for the ACT Team clients only.)
  • 5% increase in referrals from private hospitals for outpatient services
  • There will be a decrease in usage of residential treatment: length of stay at Uptowne will decrease by an average of 5 days per client (The data were for all of the clients of Forensic and Mental Health Services. In retrospect, the impact of the ACT Team on the use of residential treatment should have been measured for the ACT Team clients only.)
  • ACT Team clients will show improvement 5 points in Symptom Distress Scores on the Ohio Mental health Consumer Outcomes (This outcome was achieved.  At intake, the average score was 34.7 and at one year, the score was 27.94, an average reduction of 6.76 points.)
  • ACT Team clients will show improvement of .5 points in Quality of Life Scores on the Ohio Mental Health Consumer Outcomes (This outcome was not achieved. At intake, the average score was 3.15 and at one year, the score was 3.21. The scores reflect an improvement in quality of life, but not a change of .5 points.)
  • Clients will decrease involvement in the criminal justice system (This outcome was accomplished. Data were collected on the 66 ACT Team clients from two years prior to the ACT Team through the end of the grant in November of 2006. Sixteen of the clients had legal involvement totaling 64 offenses. Of these 64 charges, 54 occurred before the clients were involved with ACT and 10 occurred after ACT.)

Most clients had 1-3 charges before receiving ACT services.  All clients showed a decrease in court involvement following their involvement in ACT.  Ten of the 16 clients had no court involvement since joining the ACT Team.  Only one of the clients had more than two charges since starting ACT. Prior to involvement in ACT, each of the 16 clients averaged 3.5 charges over 2 years and after ACT, they averaged less than 1 charge every 2 years. There was a 63% (10 of 16) reduction in clients with new charges.

Sufficient revenue was generated on a fee-for-service basis for the program to be self-supporting at the end of the second year.

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