An evaluation of a mental health court: Process, procedure, and outcome

The purpose of this research was to conduct an evaluation of a mental health court (MHC). A conceptual model was provided to theoretically explain the MHC's functioning and the outcomes it hoped to achieve. Qualitative and quantitative data were used to examine the causal linkages specified in the conceptual model through which MHC participation in one MHC was believed to operate in reducing recidivism. Specifically, this study provides insight into how this MHC operated, who it served, what services it was able to marshal, how case decisions were made, how court monitoring influenced defendant participation and compliance, whether participation in MHC increased access to services, whether participation in MHC resulted in improved quality of life, and whether participation in MHC reduced reoffending and reoffending severity.;Qualitative data (observations, field notes, and semi-structured interviews) were used to examine court process and procedure, service utilization, defendant compliance, and defendant outcomes. These data were utilized as a link between defendants' participation in MHC and their recidivism as indicated in the developed conceptual model. Specifically, qualitative data shed light on the mechanisms (team decision making processes, open court processes, and judicial power and control to ensure defendant compliance) within MHC operation that linked MHCs to improved defendant outcomes; and qualitative data provided insight into defendants' treatment compliance and the impact of treatment services on defendants' lives.;The quantitative portion of this evaluation used a nonequivalent comparison group design with two samples of defendants: MHC subjects and traditional court subjects (TCC). The first sample, MHC subjects, included defendants who chose to participate in the MHC from September 2001 - August 2002. The second sample, TCC subjects, included defendants who were in traditional court in the study county the year before the MHC was established (1998) who would have been eligible for MHC were it in existence, that is who were mentally ill.;Multivariate and pre-test/post-test analyses were used to examine recidivism and recidivism severity to determine the impact of the MHC on the rate of re-arrest and predict factors associated with the severity of re-arrests. Results indicated that MHC defendants had a re-arrest rate approximately half that of comparable defendants in TCC; and for those who were re-arrested, MHC defendants were re-arrested for less severe offenses than comparable TCC defendants. When recidivism of MHC defendants was separated into completers and non-completers, MHC completers' rearrest rate dropped to less than one-fourth that of TCC defendants; while the re-arrest rate of MHC non-completers increased making their difference with TCC subjects nonsignificant.;Analyses examining the severity of re-arrest of TCC and MHC defendants indicated that participating in the MHC had a significant impact on the severity of rearrest. Of those MHC defendants who did re-offend, their offenses were significantly less serious than the offenses of similar TCC defendants. Last, pre-test/post-test analyses of matched samples indicated that TCC subjects were arrested more often and for more serious offenses during the post-test period as compared to the pre-test period. For the matched comparisons, MHC defendants did not experience a decrease in arrests or arrest severity after entry into the court. However, when looking at MHC completers versus non-completers, MHC completers had reduced arrests and reduced severity of re-arrests when they occurred from one year pre-court to one year post court than did MHC non-completers and TCC defendants.