King County, including the City of Seattle, Washington, utilizes several programs to assist individuals with severe and persistent mental illnesses who come in frequent contact with the criminal justice system.

FACT, or the Forensic Assertive Community Treatment program, provides community outreach to assist the individuals with locating services and housing. Referrals for the FACT program are made by the King County Mental Health, Chemical Abuse and Dependency Services Division and the Department of Adult and Juvenile Detention. The current capacity for the program is 50 participants.

The Forensic Intensive Supporting Housing program (FISH) is preventive in nature and provides “intervention strategies for those most at-risk and most in need as a means to reduce or prevent more acute illness, high-risk behaviors, incarceration and other emergency medical or crisis responses. The ‘housing first’ approach provides housing to participants without requiring participation in mental health and substance use disorder treatment; however, treatment is continually offered and provided when participants consent.” FISH provides time-unlimited services from a recovery and resiliency perspective; vocational training; housing support and stability services; medication management; benefits assistance; intensive case management; integrated mental health and substance abuse treatment; and 24-hour crisis services.

To be eligible for the FISH program, the individual must either have been found incompetent to proceed by a county Mental Health Court and, therefore, ineligible to participate in the Mental Health Court; or be a veteran with either a mental health disorder or co-occurring mental and substance use/abuse disorder.

The Impact Program serves adults who have been charged with a crime and diagnosed with co-occurring mental health and substance use/abuse disorders but have either opted into one of the therapeutic courts; incarcerated and referred by a criminal justice liaison; or are otherwise clinically appropriate and agree to participate in all aspects of the program. The Impact Program utilizes Integrated Dual Disorder Treatment (IDDT) and Moral Reconation Therapy (MRT) in conjunction with a transitional housing benefit and outpatient treatment. 

The program provides 12 months of clinic-based outpatient, integrated mental health and substance use treatment; vocational assessment, training, and support; transitional housing support and stability services; medication management; benefits assistance; intensive case management; forensic peer support/Wellness Recovery Action Plan (WRAP); Moral Reconation Therapy groups provided on a weekly basis; and assistance with transitioning to mainstream outpatient services at Community Psychiatric Clinic or another treatment provider at the end of the benefit period. A WRAP is a written plan an individual with mental illness develops to help him or her manage the mental illness and resume stability and wellness. The Impact Program offers classes to assist individuals to develop their plans.