Does the evidence support the case for mental health courts? A review of the literature.

Abstract

Mental health courts divert offenders with mental illness away from incarceration in return for participation in monitored mental health treatment. Since their inception in the late 1990 s, the proliferation of these problem-solving courts has outpaced the research on their effectiveness. A review of the literature was conducted, yielding 20 articles from peer-reviewed journals. Mental health courts were evaluated for their ability to improve psychiatric symptoms, connect individuals with behavioral health services, improve overall quality of life, and reduce recidivism rates. A majority of articles reported favorable recidivism outcomes for participants, with few evaluating their impact on therapeutic outcomes. At the present time, mental health courts represent an emerging practice, but have not yet reached the level of an evidence-based model. Existing studies of mental health courts suffer from methodological limitations, specifically, a lack of experimental design, use of nonrepresentative samples, and assessment over short timeframes. Moreover, the inherently idiosyncratic nature of these courts and the variance in reporting of court-specific eligibility criteria make cross-article comparison more difficult. It is recommended that future mental health court research examine the impact of available community services, as well as consider the effect of criminogenic risk factors, on therapeutic and recidivism outcomes.