The Rochester Forensic Assertive Community Treatment (R-FACT) model was developed at the University of Rochester by J. Steven Lamberti, MD, and Robert L. Weisman, DO, beginning with Project Link in 1995. After Project Link received the American Psychiatric Association’s Services Achievement Gold Award in 1999, Drs. Lamberti and Weisman learned that similar programs were quietly operating across the United States. This observation led them conduct the first national study of such programs, and to coin the term "forensic assertive community treatment" in the research literature. Their research revealed major differences in how existing FACT programs were designed and how they operated. To address the issue, Drs. Lamberti and Weisman obtained funding from the National Institute of Mental Health to develop and test a standardized model; the Rochester FACT model. R-FACT is characterized by four distinct elements: A high-fidelity ACT "core", identification and targeting of criminogenic risk factors, use of legal authority to promote engagement, and mental health - criminal justice collaboration for effective problem solving. A randomized controlled trial of R-FACT found that it was associated with significant reductions in convictions for new crimes, jail time, and psychiatric hospitalizations, along with significantly increased engagement in outpatient mental health services. Further work is currently underway to confirm the R-FACT model's effectiveness and its replicability in diverse communities.
Featured Publications
The First Publication on Forensic Assertive Community Treatment:
- Lamberti JS, Weisman R, Faden D. Forensic assertive community treatment: Preventing incarceration of adults with severe mental illness. Psychiatric Services 55:1285-1293, 2004.
A Framework for Preventing Criminal Recidivism Among People with Serious Mental Illness:
- Lamberti JS. Understanding and preventing criminal recidivism among adults with psychotic disorders. Psychiatric Services 58:773-781, 2007.
Forensic Assertive Community Treatment in the United States:
- Lamberti JS, Weisman RL. “Forensic Assertive Community Treatment: Origins, Current Practice and Future Directions. In: Reentry Planning for Offenders with Mental Disorders: Policy and Practice. Dlucacz H, Ed. Civic Research Institute, Kingston NY. Chapter 7:1-14, 2010.
The Role of Probation in Forensic Assertive Community Treatment:
- Lamberti JS, Deem A, Weisman RL et al. The role of probation in forensic assertive community treatment. Psychiatric Services 62:418-421, 2011.
Predictors of Arrest During Forensic Assertive Community Treatment:
- Erickson S, Lamberti JS, Weisman RL et al. The role of probation in forensic assertive community treatment. Psychiatric Services 60:834-837, 2009
Use of Legal Authority to Promote Treatment Adherence
- Lamberti JS, Russ A, Cerruli K, et al. Perceptions of autonomy and coercion among recipients of legal leverage in forensic assertive community treatment. Harvard Review of Psychiatry 22:222-230, 2014
A Framework for Promoting Effective Mental Health and Criminal Justice Collaboration
- Lamberti JS. Preventing criminal recidivism through mental health and criminal justice collaboration. Psychiatric Services 67:1206-1212, 2016
A Randomized Controlled Trial of Forensic Assertive Community Treatment
- Lamberti JS, Weisman RL, Cerulli K et al. A randomized controlled trial of the Rochester forensic assertive community treatment model. Psychiatric Services 68:1016-1024, 2017
A Review of Community-Based Intervention for Justice-Involved Patients
- Weisman RL, Lamberti JS, Ciccone JR. Community-based interventions for justice-involved individuals with serious mental disorders. In, Principles and Practice of Forensic Psychiatry, Third Edition. Rosner R, and Scott CL, Eds. CRC Press, Boca Raton, FL, 2017
A Review of Psychosis, Mania and Criminal Justice System Involvement
- Lamberti JS, Katsetos V, Jacobowitz D et al. Psychosis, Mania and Criminal Recidivism: Associations and Implications for Prevention. Harvard Review of Psychiatry 28:179-202, 2020
Fidelity Scale for Forensic Assertive Community Treatment
- Lamberti JS, Weisman RL. Essential elements of forensic assertive community treatment. Harvard Review of Psychiatry 29:278-297, 2021
Promoting Collaboration Through Inter-Agency Partnerships
- Kamin D, Weisman RL, Lamberti JS. Promoting mental health and criminal justice collaboration through system-level partnerships. Frontiers in Psychiatry 13:1-8, 2021
Cost-Effectiveness of Forensic Assertive Community Treatment
- Maeng D, Tsun Z, Lesch E, Lamberti JS: Cost-effectiveness of the Rochester forensic assertive community model. Psychiatric Services 74:358-364, 2023