Clinical Outcomes of Defendants in Mental Health Court

Abstract

Although mental health courts have been found to increase defendants' access to mental health services, they have little control over the type and quality of services that defendants receive. The fact that reductions in symptoms were not observed among defendants who received treatment in either court setting more likely reflects the chronic nature of their disorders and concerns about the adequacy of our public mental health system, rather than a failure of the mental health court.

Effectiveness of Criminal Justice Liaison and Diversion Services for Offenders With Mental Disorders: A Review

“…Although all the evaluations examined MHCs, the MHCs varied considerably in terms of size, staffing, procedures, and eligibility criteria. Significantly more MHC participants than comparator clients received services during the follow-up period (20)(21)(22)(23). Comparator clients were charged with new or violent crimes significantly earlier in the follow-up period (24).…”

“…In two studies, comparator clients and those who entered the MHC and subsequently dropped out or had their treatment terminated were more likely to experience future arrests (23,25). Only one study noted an overall increase in psychiatric symptoms during follow-up, albeit among both groups (21).…”

“…These included a single evaluation of the Broward County, Florida, MHC (20)(21)(22), a multisite study examining the effectiveness of four large, wellestablished MHCs (23), plus two further studies (24,25). All four evaluations employed a quasi-experimental design, although there were some differences in their execution.…”

“…All four evaluations employed a quasi-experimental design, although there were some differences in their execution. Two studies employed a matched design in which the MHC group and comparator group were matched on sociodemographic, criminal, and diagnostic variables (20,24), and the second study also matched groups on symptomatology (21,22). The other two studies employed a nonequivalent comparison group design whereby participants were matched on variables with statistical control for other between-group differences (23,25).…”

“…The other two studies employed a nonequivalent comparison group design whereby participants were matched on variables with statistical control for other between-group differences (23,25). Further methodological differences existed in terms of comparator groups, each of which included either jail detainees (24), court attendees from a neighboring county (20)(21)(22), participants who had attended court during the previous year (25), or participants who were eligible for the MHC but who were not referred to the service (23). Although all the evaluations examined MHCs, the MHCs varied considerably in terms of size, staffing, procedures, and eligibility criteria.…”