Nc Invests $9.5 Million In Teams To Help People With Serious Mental Illness After Their Release From Incarceration

By Rachel Crumpler

Trying to get backmost connected one’s feet successful nan organization aft leaving situation aliases jailhouse is seldom easy. People often face steep hurdles uncovering housing, employment and wellness care. For those pinch superior intelligence illness, nan modulation tin beryllium moreover much difficult.

About 2 successful 5 group who are incarcerated person a history of intelligence unwellness — astir doubly nan prevalence of intelligence unwellness wrong nan wide big population.

Many of them time off situation aliases jailhouse without a occupation aliases moreover a spot to live. Some whitethorn person a azygous outpatient intelligence wellness assignment scheduled and a 30-day proviso of their medications. Others mightiness conscionable get handed a database of resources and telephone numbers.

Too often, it isn’t enough. 

Ted Zarzar, a psychiatrist who divides his clip betwixt UNC Health and Central Prison successful Raleigh, previously told NC Health News nan play wherever group reenter their communities is particularly captious — and high-risk — for group pinch a intelligence illness. 

Without a nonstop handoff to attraction and support, Zarzar said staying unchangeable successful nan organization is astir impossible. Many group extremity up correct backmost successful a jail, situation aliases nan infirmary successful a frustrating — and costly — rhythm of recidivism. And taxpayers ft nan bill: Incarceration successful a North Carolina situation costs more than $54,000 a year. 

It’s a rhythm authorities leaders want to break — and they’re trying a caller approach.

On Nov. 3, North Carolina officials announced a $9.5 cardinal aviator program to supply intensive support to group pinch superior intelligence illnesses — specified arsenic schizophrenia, bipolar upset and chronic post-traumatic accent upset — arsenic they reenter nan organization aft incarceration. The goal: to trim repetition encounters pinch nan justness strategy and guideline group to nan thief they need.

Kelly Crosbie talks astir nan motorboat of FACT teams successful North Carolina connected Nov. 3, 2025 astatine DHHS headquarters. “Providing alternatives to incarceration erstwhile it’s appropriate, and past supporting group upon their merchandise from incarceration pinch things for illustration treatment, but besides lodging and employment are captious if we’re going to extremity nan rhythm of justness strategy involvement,” she said. Credit: Rachel Crumpler / NC Health News

These Forensic Assertive Community Treatment, aliases FACT, teams will present personalized objective and societal support to justice-involved individuals pinch superior intelligence wellness needs who besides coming a mean to precocious consequence of repeated criminal behavior. 

“​​We want to make judge that they are efficaciously connected to nan curen and supports that they need,” said Kelly Crosbie, head of nan state’s Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Use Services. “It is bully for them, it is bully for their families and it is bully for our communities.”

High-risk, high-needs population

The first FACT teams will beryllium based successful Pitt, New Hanover, Wake/Durham, Buncombe and Mecklenburg counties. Each squad will person $636,000 per twelvemonth for 3 years — backing that comes from nan $835 cardinal successful behavioral wellness backing nan authorities legislature appropriated successful nan 2023-25 authorities fund to amended nan state’s intelligence wellness system.

Teams are designed to tailor attraction based connected a person’s needs — from intelligence wellness and constituent usage curen to lodging and employment support and assistance pinch regular surviving tasks.

North Carolina’s first lady, Anna Stein, has focused connected supporting rehabilitation and reentry programs for group leaving incarceration and connected reducing stigma against group pinch constituent use and intelligence wellness disorders arsenic 2 of her apical priorities during her husband’s clip arsenic governor. She helped denote nan caller programme astatine NC DHHS office successful Raleigh.

“It is captious that we reside nan intersection of intelligence wellness needs and nan criminal justness system,” Stein said.

While nan aviator programme has been successful nan useful for much than a year, its motorboat comes amid accrued nationalist attraction connected gaps successful North Carolina’s criminal justness and intelligence wellness systems. On Aug. 22, Ukrainian exile Iryna Zarutska was stabbed to decease connected a Charlotte ray obstruction train. The man charged successful her sidesplitting had been diagnosed pinch schizophrenia and was bum astatine nan clip of nan incident. He had been arrested much than a twelve times complete 2 decades and spent much than 5 years successful situation for equipped robbery. 

‘People want support’

Data shows that group pinch intelligence illnesses are overrepresented successful incarcerated, probationary and paroled populations nationwide. Crosbie said that galore group person intelligence wellness concerns and behaviors that lend to their criminal involvement, and others spot their conditions worsen down bars. Some moreover create caller intelligence wellness conditions erstwhile they’re incarcerated. 

That’s turned jails and prisons into de facto intelligence wellness institutions — moreover though they’re ill-equipped to negociate nan growing, analyzable intelligence wellness needs of those successful their custody.

The FACT exemplary builds connected Assertive Community Treatment — a exemplary of attraction developed successful nan 1970s erstwhile psychiatric hospitals crossed nan federation closed and attraction shifted into nan community. ACT uses multidisciplinary teams who represent “walking hospitals” to bring curen straight to organization members pinch nan astir superior intelligence wellness challenges.

Forensic assertive organization treatment, aliases FACT teams, adapts that exemplary to service a justice-involved organization by pairing curen pinch interventions to trim risks for early criminal behavior.

Each North Carolina FACT squad will see 9 roles: a squad leader, psychiatrist aliases caregiver practitioner, nurse, intelligence wellness counselor, constituent usage counselor, adjacent support specialist, lodging specialist, vocational/educational master and forensic navigator. The squad members activity collaboratively to spell beyond accepted outpatient attraction and “wrap” services astir them. 

“This programme successful peculiar is for group pinch very terrible intelligence wellness issues,” Crosbie said. “These are folks that astir apt request much than erstwhile each 2 weeks a 45-minute counseling appointment. They really request intensive support done that adjacent who tin beryllium pinch them each time if that’s what they need, done a doc who they tin talk to each time if they request to, a objective societal worker who’s directing nan remainder of nan squad and providing counseling services to them. 

“It’s conscionable a overmuch much intensive level of objective services, successful summation to immoderate of those different life supports, for illustration lodging and employment.”

Crosbie said teams tin meet clients anyplace — astatine home, successful a park, a doctor’s assignment aliases moreover astatine a occupation interview.

That elasticity is cardinal for customer engagement, said Lacey Rutherford, FACT squad lead successful Buncombe County. 

Each FACT squad has nan capacity to activity pinch up to 30 clients — a smaller caseload to let unit to meet each person’s intensive needs. Team members are disposable astir nan clock, pinch nary clip limit connected really agelong they tin activity pinch personification to go unchangeable successful nan community.

The Buncombe and Mecklenburg region teams are already operating and accepting referrals, Crosbie said. The remaining teams are expected to motorboat by nan extremity of nan almanac year. Referrals tin travel from rule enforcement, tribunal officials, organization corrections, behavioral wellness attraction providers and moreover family members who deliberation personification would use from FACT services.

Rutherford, who antecedently worked for 2 years connected an assertive organization curen squad successful Buncombe and had clients pinch histories of incarceration, said she believes nan specialized teams to service justice-involved individuals will thief amended reside unmet needs. 

“People want support. They really do,” Rutherford said. “Of course, we’re going to person situations wherever group are going to beryllium resistant to this — to curen — but overall,  this is thing that these individuals haven’t had. They haven’t had support. They haven’t had group successful their area fighting for them.”

An emerging strategy

While FACT teams are caller to North Carolina, nan attack has been successful constricted usage elsewhere since nan 1990s.

One early FACT team was created successful 1997 successful Rochester, New York, by psychiatrist J. Steven Lamberti, who is besides a professor of psychiatry astatine nan University of Rochester Medical Center. Lamberti saw nan gaps betwixt nan intelligence wellness and justness systems erstwhile galore of his patients landed successful jail. The programme is still operating today, pinch Lamberti serving arsenic squad psychiatrist.

“FACT brings together champion practices successful organization intelligence wellness pinch champion practices successful crime prevention,” Lamberti told NC Health News. “It’s a mobile one-stop shop to meet people’s needs medically, psychiatrically and socially.”

He described a emblematic FACT customer arsenic personification pinch a superior intelligence unwellness who whitethorn not admit their information and has antecedently refused treatment, surviving connected nan streets without unchangeable lodging aliases income — conditions that lead to predominant encounters pinch nan justness system.

“At immoderate point, they get progressive successful a endurance crime for illustration stealing nutrient aliases fierce panhandling because they’re starving and trying to get money,” Lamberti said. “If they get arrested, they’ll spell to jail. It’s usually a misdemeanor charge, and they’ll beryllium correct backmost retired connected nan streets.” 

Breaking nan cycle, Lamberti said, requires treatment, on pinch addressing nan “criminogenic needs” that thrust justness engagement — issues for illustration lodging instability, nutrient insecurity, mediocre family relationships and more.

Lamberti published nan first insubstantial connected forensic assertive organization treatment successful 2004. At nan time, he identified 16 teams operating successful 9 states — though he noted differences successful their structure. The number of teams has grown successful caller years — aided by nan Substance Abuse and Mental Health Services Administration naming FACT among champion practices successful 2019, Lamberti said.

A caller June 2024 study led by UNC Chapel Hill interrogator Lorna Moser, who has spent her profession providing training and information of assertive organization treatment, recovered FACT teams whitethorn beryllium operating successful 19 states.

Based connected a 2024 nationalist survey, researchers estimated that astir 50 FACT teams whitethorn beryllium operating crossed 19 states. Implementation remains limited, pinch mostly only a fewer teams successful each state. Lorna Moser, who led nan survey, noted that determining nan full number of teams is difficult because there’s variability successful really FACT teams are defined. “I deliberation that there’s teams retired location that will telephone themselves a FACT team, simply because they’re serving a batch of folks that are justice-involved, but they’ve done very small to really modify what they’re doing to effort to align pinch nan model,” Moser said. Credit: Lorna Moser

In nan past year, Lamberti said astatine slightest 4 states — including North Carolina — person launched FACT teams arsenic authorities leaders look for amended ways to service this high-need population.

“People that are due for FACT services are precocious work utilizers because they’re cycling successful and retired of jails and hospitals,” Lamberti said. “That’s very costly, not conscionable financially but emotionally. These are quality beings pinch families, and they and their families are suffering immensely by watching a loved 1 go homeless, rhythm done and go incarcerated.

“For a assortment of humanitarian and financial reasons, there’s really awesome liking [in FACT teams] connected nan portion of nan states.”

FACT is simply a relatively caller work transportation model, truthful its effectiveness is still being gauged. So far, Lamberti said, nan growing grounds base is showing that “outcomes are mostly positive.” Evaluations person shown that FACT tin thief trim days spent successful jailhouse and beforehand greater usage of outpatient intelligence wellness services.

It besides appears to beryllium cost-effective. A 2022 study published successful Psychiatric Services recovered that nan Rochester FACT programme was associated pinch a $1.50 return connected finance for each $1 spent — mostly by preventing hospitalization and incarceration. And that was without factoring successful imaginable savings from different sources specified arsenic crime-related damages. 

North Carolina wellness leaders said they’ll beryllium monitoring nan outcomes of North Carolina’s FACT teams closely.

“Our extremity is that this is incredibly successful, and we’re capable to replicate this successful much counties,” Crosbie said.

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