Long-term recidivism of mental health court defendants

The first MHC was established in 1997 and now, over 15 years later, there are over 300 mental health courts in the United States. In a relatively short time these courts have become an established criminal justice intervention for persons with a mental illness. However, few studies have looked at the long-term outcomes of MHCs on criminal recidivism. Of the studies evaluating the impact of MHCs on criminal recidivism, most follow defendants after entry into the court during their participation, and only a few have followed defendants after court exit for periods of one or two years. This study follows MHC defendants for a minimum of five years to examine recidivism post-exit with particular attention to MHC completion's effect. Findings show that 53.9% of all MHC defendants were rearrested in the follow-up and averaged 15 months to rearrest. Defendants who completed MHC were significantly less likely to be rearrested (39.6% vs. 74.8%), and went longer before recidivating (17.15 months vs. 12.27 months) than those who did not complete. This study suggests that MHCs can reduce criminal recidivism among offenders with mental illness and that this effect is sustained for several years after defendants are no longer under the court's supervision.     

Courting Compliance: Case Managers as “Double Agents” in the Mental Health Court

An ethnographic study of four Midwest mental health courts was focused on how case managers influence the judicial response to offender noncompliance. Mental health courts, which bear little resemblance to traditional work group models, are staffed by teams of legal and social service professionals working collaboratively toward reducing recidivism and community reintegration for high‐risk offenders. Few studies, however, have explored how treatment providers practice their trade in this new court organization. I investigate how case management professionals, working at the intersections of the social welfare and criminal justice systems, leverage courtroom decision making that results in greater leniency or enhanced punishment. The findings suggest that mental‐health‐court case managers act as boundary spanners in terms of their strategic use of resources to facilitate treatment goals. I conclude that case managers act as “double agents” challenging the state to advocate for clemency while enforcing client rules to uphold the integrity of the court.     

Mental Health Court Outcomes: A Comparison of Re-Arrest and Re-Arrest Severity Between Mental Health Court and Traditional Court Participants

Mental health courts have been proliferating across the country since their establishment in the late 1990's. Although numerous advocates have proclaimed their merit, only few empirical studies have evaluated their outcomes. This paper evaluates the effect of one mental health court on criminal justice outcomes by examining arrests and offense severity from one year before to one year after entry into the court, and by comparing mental health court participants to comparable traditional criminal court defendants on these measures. Multivariate models support the prediction that mental health courts reduce the number of new arrests and the severity of such re-arrests among mentally ill offenders. Similar analysis of mental health court completers and non-completers supports the prediction that a "full dose" of mental health treatment and court monitoring produce even fewer re-arrests.     

Recidivism Outcomes for Suburban Mental Health Court Defendants

Mental health courts have recently emerged as one means to reduce the number of persons with mental illness in the criminal justice system. Using a post-test only comparison group design, this study examined rearrest rates for 1 year post discharge among three groups meeting admission criteria for a municipal mental health court. The rearrest rate of defendants who successfully completed the program (N = 351) was 14.5%, compared to 38% among defendants negatively terminated from the program (N = 137), and 25.8% among defendants who chose not to participate (N = 89). This positive result held even when controlling for a range of variables in a Cox regression survival analysis. Factors associated with rearrest are identified for each of the three groups.     

The impact of judge–defendant communication on mental health court outcomes

Previous research has shown that mental health courts have been successful in reducing the rates of recidivism among mentally ill offenders. However, none of these studies, to date, have examined exactly what aspects of the courts reduce these rates of recidivism and what makes them successful. The current study utilized a sample of 291 mentally ill criminal offenders participating in a mental health court to examine whether those participants who were addressed by and communicated with the judge had a reduction in recidivism rates and the severity of new charges in comparison to those who did not. The hypotheses regarding greater judge–defendant communication and recidivism were not supported. This suggests that communication in and of itself is not sufficient to reduce recidivism. Future research of a qualitative nature is essential to identify if the frequency, tone, and valence of the communication results in improved outcomes. In addition, these results may indicate a necessity for more stringent training and guidelines for the maintenance of Mental Health Courts. Results of the current study suggested differences between genders, such that females were spoken to by the judge more frequently than were men.     

Mental health, gender, and drug court completion

Drug-involved offenders report high rates of mental health problems that can negatively impact criminal justice outcomes. Yet, relatively little attention has been given to the mental health issues of drug court offenders. Therefore, this study examined 449 participants in a Delaware drug court and investigated relationships between mental health, gender, and program completion. Bivariate results indicated that gender was related to both mental health status and completion status. Multivariate findings revealed that two indicators of mental health, depression and being prescribed drugs for a psychological or emotional problem, were significant predictors of drug court completion. Policy implications include assessing the mental health status of all drug court participants at program entry so that services can be provided which aim to improve offender health and increase the likelihood of successful program outcomes. Drug courts must better meet the needs of participants with co-occurring disorders if they are to remain an effective and viable criminal justice intervention. This research was supported by grant RO1 DA12424 “Drug Court Offenders in Outpatient Treatment,” by the National Institute on Drug Abuse.     

Judicial Perspectives on Family Drug Treatment Courts

Family Drug Treatment Courts are a specialized calendar or docket that operates within the juvenile dependency court. These courts provide the setting for a collaborative effort by the court and all the participants in the child protection system to come together in a non‐adversarial setting to determine the individual treatment needs of substance‐abusing parents whose children are under the jurisdiction of the dependency court. This article is intended to give judges and others a judicial perspective on FDTCs, and to offer some assistance for those who are operating or who are considering creating one.     

Dealing with mentally ill domestic violence perpetrators: A therapeutic jurisprudence judicial model

People suffering from mental illness are increasingly referred to the domestic violence court. Yet the typical diversion programs available, including batterer's intervention programs, are inappropriate for those with serious mental illness. As a result, the Miami-Dade Domestic Violence Court has developed a new approach for dealing with this population that applies mental health court techniques in domestic violence court. This article will describe and discuss this pioneering model. It also will situate this model within the context of other problem-solving courts and discuss how the court uses principles and approaches of therapeutic jurisprudence. The paper presents some preliminary data that describe the social and legal characteristics of 20 defendants in the Domestic Violence Mental Health Court followed over a two year period between 2005 and 2007.     

Who is Diverted? Case Selection for Court‐Monitored Mental Health Treatment

Specialized courts raise questions about the decisions that bring some defendants into such courts and keep others out. Because of risks perceived in diverting mentally ill defendants, decisions to select defendants for mental health courts are especially interesting. I estimate a model of the decision to divert defendants into court‐monitored mental health treatment. I find that gender and age combine to disadvantage young male defendants and older female defendants. The findings point to the importance of structuring selection processes in the design of specialized courts. They shed light on the consequences of including treatment personnel in justice system decisions.     

Correctional Policy for Offenders with Mental Illness: Creating a New Paradigm for Recidivism Reduction

Offenders with mental illness have attracted substantial attention over the recent years, given their prevalence and poor outcomes. A number of interventions have been developed for this population (e.g., mental health courts). They share an emphasis on one dimension as the source of the problem: mental illness. Their focus on psychiatric services may poorly match the policy goal of reducing recidivism. In this article, we use research to evaluate (a) the effectiveness of current interventions, and (b) the larger viability of psychiatric, criminological, and social psychological models of the link between mental illness and criminal justice involvement. We integrate theory and research to offer a multidimensional conceptual framework that may guide further research and the development of efficient interventions that meaningfully reduce recidivism. We hypothesize that the effect of mental illness on criminal behavior reflects moderated mediation (i.e., the effect is direct in the case of one subgroup, but fully mediated in another); and that the effect of mental illness on other “recidivism” is partially mediated by system bias and stigma. We use this framework to propose three priorities for advancing research, articulating policy, and improving practice.     

Enrollment in Mental Health Courts: Voluntariness,Knowingness, and Adjudicative Competence

Mental health courts (MHCs) are rapidly expanding as a form of diversion from jails and prisons for persons with mental illness charged with crimes. Although intended to be voluntary, little is known about this aspect of the courts. We examined perceptions of voluntariness, and levels of knowingness and legal competence among 200 newly enrolled clients of MHCs at two courts. Although most clients claimed to have chosen to enroll, at the same time, most claimed not to have been told the court was voluntary or told of the requirements prior to entering. The majority knew the “basics” of the courts, but fewer knew more nuanced information. A minority also were found to have impairments in legal competence. Implications are discussed.     

Drug Court through the Lenses of African American Women: Improving Graduation Rates with Gender-Responsive Interventions

Drug courts began in the United States in 1989, and nearly three decades of evidence has shown that drug courts are more effective than other criminal justice interventions at reducing criminal recidivism. There has, however, been a trend in some drug courts where African Americans are less likely to graduate than their White counterparts, which is concerning because evidence has also shown that graduating the program reduces the odds of recidivating. Little is known about African Americans’ experiences in drug court, and this is the first known qualitative study to ask African American women (N?=?8) about the most helpful aspects of drug court that support them in graduating and how the drug court could be more helpful in supporting them to graduate. The women felt that the drug court judge was their advocate and understood the unique challenges they faced with balancing the demands of drug court with motherhood. Conversely, the women felt that they were not receiving effective, gender-responsive treatment for their substance use disorders, which was a barrier to them graduating drug court. The findings are discussed in reference to drug court practice and future research.     

The Courts in a Fragmented Criminal Justice System

The U.S. President's Commission on Law Enforcement and Administration of Justice under President Johnson in 1967 outlined a central role for courts in the criminal justice system. That role, however, has been somewhat diminished by the dominance of plea bargaining and the legislative enactment of mandatory minimum sentences that limit judges’ discretion. At the same time, judges have become more involved in specialized courts dealing in cases involving drugs and mental illness. A major topic of concern is the lower courts, which in many areas have changed little since the 1960s Commission. In those places, the traditional adversary process is not operating well, with many defendants pleading guilty unnecessarily in a system that may be designed primarily to collect fees. In violent crime cases, the imposition of capital punishment remains a controversial issue for states that is not likely to be resolved by a new national commission. The central court functions of sentencing and overseeing plea bargains are discussed elsewhere in this volume.     

Against the Grain: Therapeutic Judging in a Traditional Family Court

The last several decades have seen a proliferation of specialized courts, including within the family court system, that deviate from the adversarial model, and that rely on therapeutic jurisprudence and other problem‐solving techniques. Whether and how traditional family courts can incorporate the best practices of these specialized courts is a largely understudied area. Drawing from ethnographic observations of a traditional urban family court, this study finds that some judges are able to transform nontherapeutic courtrooms into therapeutic ones despite obstacles. These “against the grain” actors, who act contrary to the institution's dominant norms and practices, demonstrate how therapeutic jurisprudence and other problem‐solving techniques can be utilized in traditional courtrooms.     

Patterns of Practice in Mental Health Courts: A National Survey

Mental health courts (MHCs) represent an important new development at the interface of the criminal justice and mental health systems. MHCs are criminal courts for persons with mental illness that were in part created to divert this population from jail/prison into community treatment. MHCs are proliferating rapidly despite limited knowledge regarding their characteristics or their efficacy. We surveyed the entire population of adult MHCs in the United States, n = 90. In the past 8 years, MHCs have been created in 34 states, with an aggregate current caseload of 7,560 clients in MHCs nationally. Most courts (92%) reported using jail as a sanction for noncompliance, if only rarely. Further, jail sanction use was significantly predicted by increased judicial supervision and number of felons in the court. Implications for MHCs and social monitoring are discussed.     

Sustained Outcomes? an Exploratory Study of Juvenile Drug Courts and Long-Term Recidivism

This exploratory study examined juvenile drug courts’ effect on adulthood recidivism. Utilizing a twelve-year average follow up time, adult recidivism rates were compared between previous juvenile drug court participants and a comparison group of juveniles who participated in traditional probation. Linear regression models indicated limited recidivism effects of drug court on arrests or convictions into adulthood. The findings suggest that gender and race may play a role in how justice-involved juveniles interact and experience juvenile drug court, highlighting the need for gender-responsive and culturally responsive policies, practices, and programs within juvenile drug courts. Recommendations are made regarding future research areas and ways to potentially improve long-term juvenile drug court outcomes.     

The Courts,Intimate Partner Violence and Mental Illness: The Case of Dwight Lamon Jones

Through the lens of the high-profile spree killing perpetrated by Dwight Lamon Jones in 2018 in Phoenix, Arizona, this article examines the way the criminal and civil courts grappled with assessing the significance, extent, and outcome of the IPV and abuse directed at Dr. Connie Jones, Dwight Jones’s former wife. The case is unusual, not least because Dr. Jones had an upper middle-class income and numerous resources IPV victims do not normally enjoy. Nevertheless, she felt the courts let her family down. Journalists, victim advocates, and others also criticized the Arizona courts. The article outlines the spree killing and the criticisms of the courts, narrates Jones over a period of nine years including the IPV and mental illness, and, through the work of the Study Committee convened by Arizona Chief Justice Bales, explores the potential use of IPV risk assessments in the courts, particularly the family court, and related matters. It concludes with recommendations regarding possible preventive interventions in IPV cases, including those addressing mental illness.