Court Diversion Research Articles

Mental health diversion courts: a two year recidivism study of a South Australian mental health court program.

The need to develop specialized judicial processes to deal with offenders with mental illnesses is now widely recognized and has led to the introduction of mental health court diversion programs around the world. At present, however, there is only limited evidence from which to assess the impact of these initiatives. This paper describes the South Australian model of diversion, with specific reference to the relationship between identified participant characteristics, program compliance rates, and re-offending outcomes. The results of a two-year recidivism study suggest that involvement with the program has a positive impact on recidivism, but that this is independent from the individual's level of success in the program. Lower risk offenders were more likely to achieve successful outcomes than those in the higher risk categories. The implications of these results, as well the factors that might inform the ongoing development of mental health court programs, are discussed.

Making links between sex work, gender and victimisation: the politics and pedagogies of John Schools

This article will explore the links between sex work, gender and victimisation. It will draw on the literature on victims and victimology, as well as the literature on sex work, to explore the ways in which sex work, gender and victimisation are presented at John Schools. These are court diversion educational programmes that teach those arrested for soliciting for the purposes of buying sex the negative consequences of their actions and are currently operating in parts of the USA, Canada, the UK and South Korea. Focusing on a case study of a John School in England, it shows how the pedagogies of the John School are inherently political and structured by the local and extra-local contexts in which it is situated. It also demonstrates the small but significant influence of radical feminist ideas and tropes in the John School and the ways in which the John School presents victimisation relationally as male clients causing hidden harms to victims, most notably residents and female sex workers. Here, the active construction of both the victim and offender identity is critically reflected on.

Individual Factors Predicting Mental Health Court Diversion Outcome

Objective: This study examined which individual factors predict mental health court diversion outcome among a sample of persons with mental illness participating in a postcharge diversion program. Method: The study employed secondary analysis of existing program records for 419 persons with mental illness in a court diversion program. Results: Analysis revealed that unemployment was a significant predictor of program completion. Employment and symptom severity were predictive of partial program completion, while participants who did not complete programming were more likely to have a concurrent disorder and were more likely to be residentially unstable than participants who did complete programming. Conclusion: These findings discuss characteristics of persons with mental illness, as they relate to the likelihood of completing diversion programming.

Mental Health Courts, Court Diversion, and Canada's Obligations under the United Nations Convention on the Rights of Persons with Disabilities

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) is often recognized as emphasizing a “universalist” approach to difference that discourages the identification and segregation of particular groups based on their characteristics. This emphasis raises questions about Canada's Mental Health Courts (MHCs) and court-diversion programs that identify and respond to people with mental disabilities as a group and can be seen to reflect a “minority rights” approach to the accommodation of difference. These questions need to be addressed to ensure that Canada complies with its international obligations under the CRPD.

Court Diversion for Juveniles with Mental Health Disorders

Mental health diversion programs show promise in effectively addressing the treatment needs of youth with mental health and substance use disorders who come in contact with the justice system.

Implementing a court diversion and liaison scheme in a remand prison by systematic screening of new receptions: a 6 year participatory action research study of 20,084 consecutive male remands

BackgroundA mental health needs assessment in the Irish prison population confirmed findings from other jurisdictions showing high prevalence of severe mental illness, including psychosis amongst those newly committed. We implemented a participatory action research approach in order to provide an integrated mental health prison in-reach and court liaison service for this population.ResultsFollowing extensive consultation, a two stage screening process was developed which was supplemented by an inter-agency referral management system. During the six years 2006–2011, all 20,084 new remands to the main remand prison serving 58% of the national population were screened. Following the first stage screen, 3,195 received a comprehensive psychiatric assessment. Of these 561 (2.8%) had symptoms of psychosis – corresponding to the prior research finding – and 572 were diverted from the criminal justice system to mental health services (89 to a secure forensic hospital, 164 to community mental health hospitals and 319 to other community mental health services).ConclusionsWe have shown that it is possible to match research findings in clinical practice by systematic screening, to sustain this over a long period and to achieve consistent levels of diversion from the criminal justice system to appropriate mental health services. The sustained and consistent performance of the model used is likely to reflect the use of participatory action research both to find the most effective model and to achieve wide ownership and cooperation with the model of care.

A Comparison of Domestic Violence Recidivism Rates of Defendant-Initiated Diversion and Court-Mandated Treatment

This study examines court records of 244 defendants assigned to court-connected treatment to determine whether “defendant-initiated diversion” offenders recidivated less than defendants who were mandated by the court to undergo treatment. The study population consisted of 140 defendants who voluntarily opted to participate in a domestic violence (DV) court diversion program and 104 convicted offenders who were ordered by the court to complete treatment as part of their sentence of probation. Defendants who had prior felony or DV convictions were not accepted into the diversion program. A logit model analysis revealed a statistically significant negative relationship between diversion completion and DV recidivism during the 24 months after treatment completion or case closure. These results illustrate the importance of including defendant-initiated diversion for low risk offenders as part of a court system strategy to address DV.

How Collaborative the Collaboration? Assessing Interagency Collaboration within a Juvenile Court Diversion Program

ABSTRACTJuvenile delinquency with co‐occurring substance abuse and mental health disorders has become an increasing problem within the United States. In part this can be attributed to the excessive number of delinquent youth entering the juvenile justice system with untreated substance abuse and/or mental health disorders. In an effort to combat this problem, interagency collaborations have been formed to provide more effective treatment services. One such interagency collaboration is the JETS Program. This study identifies the strengths and limitations of establishing an interagency collaboration within the first year of a juvenile treatment court's inception.

National court diversion service welcomed

The government has laid out plans for health services in the criminal justice system that will include the establishment of a national court diversion service by 2014 and better mental health care for young offenders.

The DUNDRUM-1 structured professional judgment for triage to appropriate levels of therapeutic security: retrospective-cohort validation study.

BackgroundThe assessment of those presenting to prison in-reach and court diversion services and those referred for admission to mental health services is a triage decision, allocating the patient to the appropriate level of therapeutic security. This is a critical clinical decision. We set out to improve on unstructured clinical judgement. We collated qualitative information and devised an 11 item structured professional judgment instrument for this purpose then tested for validity.MethodsAll those assessed following screening over a three month period at a busy remand committals prison (n = 246) were rated in a retrospective cohort design blind to outcome. Similarly, all those admitted to a mental health service from the same prison in-reach service over an overlapping two year period were rated blind to outcome (n = 100).ResultsThe 11 item scale had good internal consistency (Cronbach's alpha = 0.95) and inter-rater reliability. The scale score did not correlate with the HCR-20 'historical' score. For the three month sample, the receiver operating characteristic area under the curve (AUC) for those admitted to hospital was 0.893 (95% confidence interval 0.843 to 0.943). For the two year sample, AUC distinguished at each level between those admitted to open wards, low secure units or a medium/high secure service. Open wards v low secure units AUC = 0.805 (95% CI 0.680 to 0.930); low secure v medium/high secure AUC = 0.866, (95% CI 0.784 to 0.949). Item to outcome correlations were significant for all 11 items.ConclusionsThe DUNDRUM-1 triage security scale and its items performed to criterion levels when tested against the real world outcome. This instrument can be used to ensure consistency in decision making when deciding who to admit to secure forensic hospitals. It can also be used to benchmark admission thresholds between services and jurisdictions. In this study we found some divergence between assessed need and actual placement. This provides fertile ground for future research as well as practical assistance in assessing unmet need, auditing case mix and planning care pathways.

Mental health and addiction services in the criminal justice system: Where do we sit?

Mental health and addiction services in the criminal justice system: Where do we sit?

Is teen court the best fit? Assessing the predictive validity of the Teen Court Peer Influence Scale

Purpose Despite the increased use of teen courts for first time, non-violent juvenile offenders, there has been little research examining the decision-making processes regarding which offenders are best suited for this type of intervention. The Teen Court Peer Influence Scale (TCPIS) was developed to assist juvenile justice officials in making these determinations. The purpose of the present research is to determine the predictive validity of the TCPIS. Methods The TCPIS was administered to a nonprobability sample of teen court participants in Florida (N = 404) between September 2006 and February 2007. Dependent measures for the validity analysis were developed from the Youth Self-administered Questionnaire and included social bonds, prosocial attitudes, delinquent peer associations, positive perceptions of teen court, and perceived delinquency. Results All hypotheses were supported with the TCPIS global score accounting for a significant amount of variance among each of the delinquency measures strengthening the predictive validity of the measure. Conclusions These preliminary findings are positive regarding the predictive validity of the TCPIS. With additional research, the TCPIS could be a useful tool for decision-makers regarding which juvenile offenders are the best fit for teen court diversion programs.

Confirmatory Analyses of the School Refusal Assessment Scale-Revised: Replication and Extension to a Truancy Sample

School absenteeism and school refusal behavior are prevalent and serious issues for youth, but few measures have been developed specifically for this population. The School Refusal Assessment Scale-Revised (child and parent versions) provides clinicians with a profile of the relative strength of four functions or maintaining variables regarding school refusal behavior. The scales have been previously tested largely on clinical samples in outpatient treatment settings, however. This study examined 216 youth with primary school refusal behavior and their parent/guardian referred to a community-based truancy court or truancy diversion setting for problematic absenteeism. The four-factor structure of the scales (Kearney Journal of Psychopathology and Behavioral Assessment 24:235–245, 2002a; Journal of Psychopathology and Behavioral Assessment 28:139–144, 2006) was supported via confirmatory factor analysis and specific functions were associated with specific symptom sets as predicted. The results help extend the generalizability of the scales to youths and their families who are more ethnically diverse and referred to a legal process.

Preliminary analysis of the Northern Territory's illicit drug court diversion program highlights the need to examine lower program completion rates for indigenous clients

Court drug diversion programs are now available in all jurisdictions in Australia, but there is increasing evidence that such programs have differing success rates for certain client populations, including indigenous clients. This study investigates client characteristics, program completion rates and factors associated with retention, for all 484 clients admitted to the Northern Territory's Court Referral and Evaluation for Drug Intervention and Treatment 12 week illicit drug pre-sentence court diversion program between July 2003 and December 2008. Client data were collected by court clinicians as part of the face-to-face assessment interview and treatment outcomes were recorded. Multivariate logistic regression analysis showed that indigenous clients were significantly less likely to complete their treatment than non-indigenous clients, as were clients who were younger, male, had an educational level of Year 10 or less, were unemployed, had a previous custodial order and used drugs other than cannabis. The lower program completion rates for indigenous clients are consistent with findings from other Australian studies and highlight the need to further explore and address factors contributing to this result.

What will the future bring? Prison mental health care in England

Abstract Evidence suggests that, compared to the population as a whole, offenders are considerably more likely to suffer from mental health problems (especially from severe/multiple mental health problems). Some authors estimate that the proportion of people with mental health problems in prisons is as high as 90 per cent (e.g.Roberts and Cobb, 2008). Recent research published in cjm advocates putting more robust court diversion mechanisms in place which would ensure that offenders with mental illness are directed into mental health services (Roberts and Cobb, 2008). What happens however, when these mechanisms are not in place or do not perform as expected, and offenders with mental health problems end up in prisons?

Lord Bradley's review of people with mental health or learning disabilities in the criminal justice system in England: All not equal in the eyes of the law?

In December 2007, Lord Bradley was asked by the Government, in a six‐month period, to review court liaison and diversion schemes for mentally ill people. A year and a half later, and having extended the brief to encompass the entire criminal justice system, Lord Bradley has reported. The Government has now responded to Bradleys’ findings (Ministry of Justice, 2009) so it is timely to comment on the review particularly in relation to prisons in England. The English prison population is almost at its highest ever level and currently stands at around 82,000 people ‐ according to the Prison Service’s standard of certified normal accommodation, the prison population is now 8000 more than it should be. As HM Chief Inspector of Prisons, Anne Owers, has noted ‘activity and support from staff . . . were the two things thought to be most helpful by prisoners with mental health and emotional problems, in over‐crowded and under‐resourced prisons these essential elements of care are at a premium’ (HM Inspectorate of Prisons, 2007).

Neglecting the mental health of prisoners.

From first contact with the police to release from prison, people with mental ill health who come into conflict with the law often find that their mental health needs are neglected while they are under the authority of the criminal justice system. In 2008, the Prison Reform Trust surveyed independent monitoring boards in England and Wales, asking them to comment on mental health care. Topics included the adequacy of court diversion schemes, assessments carried out in prison reception units, and preparations to ensure continuity of care upon release. The responses documented some of the consequences of neglect in prisons in England and Wales. Over half of the boards felt that they frequently saw prisoners who were too ill to be in prison. Boards also expressed concerns about assessment processes in prison reception areas, which were by no means adequate to identify mental health problems. A number of boards stated that, too often, people with severe mental illnesses are held in segregation units, where they endure an impoverished regime. The boards observed that many prisons lack any means of identifying people who have learning disabilities, and often their disabilities restrict their capacity to engage fully with the regime.

Court outcomes for clients referred to a community mental health court liaison service

Court liaison and diversion services come in a variety of forms, but the similarities and differences between these services are not well characterized. Findings from a six-year audit of the Newcastle (Australia) Mental Health Court Liaison (MHCL) service are reported, including client characteristics, offence and service contact profiles, court outcomes, and interrelationships among these variables. During the audit period, there were 2383 service episodes by 1858 clients (1478 males, 380 females). Drug and alcohol disorders (40.9%) and psychotic disorders (17.0%) were the most prevalent mental health problems, while assault (23.1%), theft (23.1%), offences against justice procedures (15.4%), driving offences (13.4%) and malicious damage to property (8.3%) were the most frequently recorded charges. Among service episodes with a finalized court outcome, 70.0% involved a punishment (bond: 49.5%; jail term: 29.7%). Females were less likely to be punished, but more likely to have their case dismissed under sections of the relevant Act that required further assessment and monitoring. Being married, or having an adjustment or drug and alcohol disorder, were also associated with an increased likelihood of punishment, while clients with a psychotic or bipolar disorder were less likely to be punished. Among clients who were punished, those referred from inpatient mental health services were more likely to receive a non-jail punishment, while unemployed clients were more likely to be jailed. A substantial proportion of clients had court outcomes that required an ongoing involvement with local mental health services. By being part of community mental health services, our MHCL service is able to work efficiently and effectively with the criminal justice system, while facilitating ready access to existing mental health services and continuation of care.

Young people who attend specialist alcohol treatment: who are they and do they need special treatment?

Patterns of drinking in adolescence and young adulthood may have major short term impacts and influences on later drinking, yet little is known about the characteristics of young people who seek help for alcohol problems. Here we examine the characteristics of treatment episodes for adolescents and young adults who present to specialist alcohol treatment in New South Wales (NSW). The NSW Minimum Data Set for Alcohol and Other Drug Treatment Services was examined for all alcohol-related treatment episodes (N=21,012) reported between July 2004 and June 2005. We compared treatment episodes for adolescents aged 12-19 years, young adults aged 20-29 years and clients aged 30 years or more for their demographics, drug use and service delivery characteristics. Clients aged under 30 years were significantly more likely to be referred into specialist treatment by a police, court or criminal justice diversion program compared with older clients (adolescent: OR=3.7, 95%CI: 3.1-4.4; young adult: OR=2.2, 95%CI: 1.9-2.4). Concern about cannabis use was significantly higher among younger clients (adolescents: OR=2.8 95%CI: 2.3-3.3; young adults: OR=2.1, 95%CI: 2.0-2.4) than those aged 30 years or more. Younger clients were also more likely to be of Indigenous origin or seen in a rural setting. Adolescent and young adult alcohol treatment clients include a higher proportion of clients who are Indigenous, legally coerced, and who have concerns with polydrug use. Service providers should seek to tailor their treatment programs to better meet these unique needs and to better attract young people into voluntary treatment.

People with an Intellectual Disability in the Australian Criminal Justice System

Intellectual disability (ID) is not accurately identified early enough in the criminal justice system. The extent to which each jurisdiction addresses the needs of persons with ID is inconsistent. Magistrate Court diversion programmes aiming to identify defendants with ID needs vary throughout Australia. This article argues the need for a national approach for the diversion of persons with ID from the criminal justice system. This will be important for persons with and without coexisting mental illness and will affirm international developments protecting the rights of persons with ID (including those in the criminal justice system) to improved and accessible health care.