Meta-analytic reviews on the efficacy of adult and youth mental health courts

Over the past decade mental health courts have proliferated in an attempt to divert persons with mental illness from the traditional criminal justice system to a type of court (MHC) that is considered to be better equipped to handle their more complex needs. The overall aim of this thesis was to conduct a critical evaluation of the unpublished and published MHC literature. Meta-analytic reviews were employed to quantitatively explore the efficacy of MHCs in reducing criminal offenses, recidivism, and improving clinical outcomes in young and adult offenders across Canada and the United States. A total of 15 MHC sites were included in each of the reviews on criminal offences while 5 studies were included in the review of clinical outcomes. Summary effect sizes demonstrated that MHCs are related to reductions in criminal offences when comparing criminal offences prior to and following MHC involvement (d = -.37), and that MHC participants recidivated less than comparison samples following MHC involvement (d = -.19). Studies with higher levels of internal validity were found to be related to a smaller reduction in recidivism. Results showed that MHC participation is not related to improvements in clinical outcomes (d = -.02). More rigorous studies comparing MHC effectiveness to preexisting established practices is needed.