| Mental health courts (MHC) are expanding across the nation but the evidence base is scant and involves substantial gaps in research. Relatively little is known about mental health and substance use treatment or the ways in which consumers experience treatment in the context of MHC programs. Although reduced recidivism and increased service use are documented outcomes associated with MHC participation, it is unclear as to what factors contribute to these outcomes. The current study addresses gaps in research by exploring treatment and outcomes from the perspective of consumers participating in two different MHCs (N=80). In order to both explore consumer perspectives of MHCs and estimate the association between key factors (i.e., procedural justice, social support, social network factors, and the therapeutic alliance) and clinical and legal outcomes, a mixed-method design that draws from multiple data sources and related literature is utilized to address research questions and contextualize data. Data from in-depth semi-structured interviews and survey measures administered in structured interviews with consumers are triangulated with key informant interviews and administrative data. Study results suggest that some MHC participants find MHCs to be a way to provide assistance to people in need while others view MHCs as a contractual agreement requiring consumers to relinquish control over life decisions in exchange for freedom. Quantitatively measured factors including perceptions of procedural justice, conflict with caseworkers, perceptions of support, and network factors are significantly associated with both legal and clinical outcomes. Through thematic analysis, consumers identified structure and accountability, supportive services, treatment, being treated well, instilling motivation, and changing environments as salient factors that they believe promote personal change. The results have implications for social work practice, MHC policy, and research. |
