Study: Mental Health Courts Significantly Reduce Repeat Offenses, Jail Time

New research from North Carolina State University finds that mental health courts are effective at reducing repeat offending, and limiting related jail time, for people with mental health problems – especially those who also have substance use problems.

“Previous research has provided mixed data on how effective mental health courts are at reducing recidivism, or repeat offending, for people with mental health problems,” says Sarah Desmarais, an associate professor of psychology at NC State and senior author of a paper on the research. “We wanted to evaluate why or how mental health courts may be effective, and whether there are specific characteristics that tell us which people are most likely to benefit from those courts. The goal here is to find ways to help people and drive down costs for state and local governments without impinging on public safety.”

Mental health courts (MHCs) are county-level courts designed to divert offenders with mental health problems from jail, instead referring them to community-based treatment programs. The goal is to address the underlying mental health problems that contributed to a crime in order to prevent repeat offenses. There are currently more than 300 mental health courts in the United States.

For their study, researchers evaluated 97 people in Minnesota who had mental health problems and had committed misdemeanors or gross misdemeanors, ranging from shoplifting to threatening someone. Fifty-seven of the people went through an MHC, while the other 40 went through the conventional court system.

Specifically, the researchers looked at the characteristics of every offender and how each of them fared in the year following their court appearance.

“The short version is that MHCs work,” Desmarais says.

Offenders that went through normal courts spent 1.6 times more days in jail for repeat offenses than offenders who went through an MHC. And the effect was much stronger when researchers looked at those offenders who went through an MHC and actually completed their MHC treatment programs.

“Offenders who went through traditional courts had 1.8 times more charges and spent almost five times more days in jail for repeat offenses, when compared to offenders who graduated from the MHC after completing their terms of participation,” says Evan Lowder, a Ph.D. student at NC State and lead author of the paper.

The researchers also found that offenders who participated in the MHC who also had substance use problems had a 4.76 times greater decrease in jail time from repeat offending when compared to offenders without substance use problems who participated in the MHC.

“MHCs appear to be especially effective at reducing recidivism for offenders with mental health and co-occurring substance use problems,” Lowder says.

“This tells us that MHCs are effective at reducing repeat offenses, which reduces the burden on law enforcement, the judicial system and – ultimately – the taxpayer,” Desmarais says.

The paper, “Recidivism Following Mental Health Court Exit: Between and Within-Group Comparisons,” was published online Nov. 23 in the journal Law and Human Behavior. The paper was co-authored by Daniel Baucom, an undergraduate at NC State.

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Note to Editors: The study abstract follows.

“Recidivism Following Mental Health Court Exit: Between and Within-Group Comparisons”

Authors: Evan M. Lowder, Sarah L. Desmarais, and Daniel J. Baucom, North Carolina State University

Published: Nov. 23, Law and Human Behavior

DOI: 10.1037/lhb0000168

Abstract: Over the past decade, Mental Health Courts (MHCs) have spread rapidly across the U.S. These courts aim to reduce recidivism among adults with mental illnesses through diversion into community-based treatment. Extant research suggests that MHCs can be effective in reducing recidivism, but also demonstrates that effectiveness varies as a function of characteristics of the participants (e.g., criminal history) and the program (e.g., coercion). Less is known regarding the extent to which process-related factors (e.g., length of participation, time between referral and receipt of services) impact effectiveness. Prior research also is limited by a focus on recidivism during MHC as opposed to postexit. To address these knowledge gaps, we examined recidivism 1 year postexit for a group of MHC participants (n = 57) and offenders receiving treatment as usual (TAU; n = 40), total N = 97. We also investigated the influence of individual characteristics and process factors on changes in jail days 1 year preentry to 1 year postexit for MHC participants. Overall, results provide some evidence supporting the effectiveness of MHCs. MHC participants had significantly fewer jail days, but not charges or convictions, relative to TAU participants. Among MHC participants, graduation from the MHC, presence of co-occurring substance use, and longer length of MHC participation were associated with greater reductions in jail days. Other process factors were unrelated to reductions in recidivism. Findings suggest that MHCs may be particularly effective for high-risk participants and that time spent in a MHC has positive effects on recidivism, regardless of graduation status.