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Completed

NCT Number: NCT07592884

Rochester Forensic Assertive Community Treatment Model in Minnesota

This study evaluates the Rochester Forensic Assertive Community Treatment (R-FACT) model in Minnesota. R-FACT is an enhanced version of Assertive Community Treatment designed to support individuals with serious mental illness who are involved in the criminal justice system.

Participants were randomly assigned to receive either the R-FACT intervention or standard outpatient mental health services. The study examines whether R-FACT reduces criminal justice involvement, improves mental health outcomes, and enhances community functioning compared to usual care over a 24-month follow-up period.

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Key information

Conditions

Schizophrenia Behavior Bipolar Disorder Bipolar and Related Disorders Criminal Behavior Mental Disorders Mood Disorders Schizophrenia Spectrum and Other Psychotic Disorders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Rochester Medical Center

Rochester, New York, 14642, United States

About this study

The R-FACT intervention includes a multidisciplinary team approach with reduced caseloads, enhanced supervision, and collaboration with criminal justice stakeholders.

This randomized controlled trial evaluates the effectiveness of the Rochester Forensic Assertive Community Treatment (R-FACT) model in Minnesota. R-FACT is a modified Assertive Community Treatment (ACT) model developed to address the needs of individuals with serious mental illness who are at high risk for criminal justice involvement. The model integrates best practices in community mental health (high-fidelity ACT) with best practices in community correctional supervision (Probation officers trained in Effective Practices in Community Supervision - EPICS) The study was conducted across two counties in Minnesota and enrolled adults with serious mental illness who were on probation or undergoing correctional facility release to probation. Participants were randomized to either the R-FACT intervention or standard outpatient mental health treatment.

The R-FACT intervention consists of a high-fidelity ACT team that collaborates closely with specially assigned probation officers who provide community correctional oversight of all R-FACT service recipients. The comparator group received usual care through existing outpatient mental health services along with standard probation.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 or older.
  • DSM-5 diagnosis of a psychotic disorder, including schizophrenia, schizoaffective disorder, bipolar disorder, or major depression with psychotic features.
  • Adequate command of English to understand study instructions.
  • Capacity to provide informed consent.
  • Under community correctional supervision or undergoing prison release planning at the time of enrollment.

Exclusion criteria

  • Age under 18.
  • Lack of a psychotic disorder diagnosis.
  • Inability to speak English.
  • Lack of capacity to provide informed consent.
  • Absence of community correctional supervision or of release planning.
  • Presence of legal oversight in the community from a source other than probation or community corrections. Examples include having legal oversight from a mental health court, a drug court, or from an assisted outpatient treatment (AOT) program.

Treatment and study plan

R-FACT intervention

Behavioral

A structured, team-based model of care adapted from Assertive Community Treatment (ACT) that provides intensive, community-based psychiatric services with integrated supervision and coordination with criminal justice and social service systems. The model emphasizes reduced caseloads, frequent participant contact, continuity of care, and collaborative problem solving between mental health and criminal justice staff with an emphasis on finding therapeutic alternatives to punishment.

Standard Outpatient Treatment

Behavioral

Routine outpatient mental health services delivered through existing community systems, including standard psychiatric care and case management without the enhanced structure or intensity of the R-FACT model.

Primary outcomes

  1. Mean Total Number of Days Incarcerated During the 24 Month Follow Up Period

    Time frame: Randomization to 24 months after randomization

    Incarceration days are measured using administrative correctional records. For each participant, the total number of days incarcerated during the 24 month follow up period is calculated from correctional database records. The outcome is reported as the mean total number of incarceration days per participant within each study arm. Higher values indicate more time spent incarcerated, and lower values indicate less time spent incarcerated.

Secondary outcomes

  1. Mean Total Number of Arrests During the 24 Month Follow Up Period

    Time frame: Randomization to 24 months after randomization

    Arrests are measured using administrative criminal justice records. For each participant, all arrests occurring during the 24 month follow up period are counted. The outcome is reported as the mean total number of arrests per participant within each study arm. Higher values indicate more arrests.

  2. Mean Total Number of Convictions During the 24 Month Follow Up Period

    Time frame: Randomization to 24 months after randomization

    Convictions are measured using administrative criminal justice records. For each participant, all convictions occurring during the 24 month follow up period are counted. The outcome is reported as the mean total number of convictions per participant within each study arm. Higher values indicate more convictions.

  3. Mean Total Number of Community Supervision Violations During the 24 Month Follow Up Period

    Time frame: Randomization to 24 months after randomization

    Community supervision violations are measured using administrative criminal justice records. For each participant, all probation or parole violations occurring during the 24 month follow up period are counted. The outcome is reported as the mean total number of violations per participant within each study arm. Higher values indicate more violations.

  4. Mean Total Number of Jail Stays During the 24 Month Follow Up Period

    Time frame: Randomization to 24 months after randomization

    Jail stays are measured using correctional administrative records. For each participant, the number of separate jail admissions occurring during the 24 month follow up period is counted. The outcome is reported as the mean total number of jail stays per participant within each study arm. Higher values indicate more jail admissions.

Sponsors and collaborators

Lead sponsor

University of Rochester

Other

Collaborators

  • Arnold Ventures

Registry information

Official study title

A Randomized Controlled Trial of the Rochester Forensic Assertive Community Treatment Model in Minnesota

Acronym: R-FACT

Important dates

Study start
2020
Primary completion
2025
Study completion
2025
First posted
May 18, 2026
Registry last updated
May 26, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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