One-Year Outcomes of a Randomized Trial of Case Management with Seriously Mentally Ill Clients Leaving Jail

It was hypothesized that clients receiving case management services will improve to a moderate extent in terms of a variety of psychosocial and clinical outcomes compared with clients served by the usual system of care. It was further hypothesized that clients served by an Assertive Community Treatment (ACT) team will have significantly greater improvement than clients served by forensic case managers working individually. Two hundred seriously mentally ill inmates leaving jail were assigned to three conditions, and 94 remained in the study at 1 year. One-year outcomes were analyzed by service condition, using a hierarchical block discriminant function analysis. Contrary to the hypothesis, more clients in the experimental condition returned to jail within a year. No differences were found among the three conditions in social or clinical outcomes. Greater jail recidivism among clients receiving the more intensive service raises questions concerning tendencies to emphasize monitoring with this population.