Mental health courts as an effective form of jail diversion – but at what cost?

A final chapter of the research on the effectiveness of mental health courts is the fiscal impact of diversion compared with ordinary criminal justice processing. We show that mental health courts successfully divert justice-involved persons with serious mental illness from the criminal justice system and into community-based treatment. We find that ollowing entry into mental health court and being released into the community, participants have higher rates of treatment engagement than the “treatment as usual” sample. Public safety and behavioral health outcomes improve but at a fiscal cost to communities and provide savings. This phase of the study compares the direct fiscal costs and savings of mental health courts using standardized rates of criminal justice and treatment costs. By using propensity scoring, we also take into account differences in sites and characteristics that might affect service use and costs. To determine the fiscal impact of mental health courts on communities, we compare the treatment and criminal justice costs in the 3 years pre-arrest with the 3 years post-arrest for the MHC and TAU samples. We discuss how the implementation of mental health courts increases demand for community-based services, thus potentially driving up short term costs. Savings accumulate over time when compared with typical criminal justice processing and provision of community treatment of similar justice-involved persons with mental illness. These findings provide evidence for policy makers, criminal justice administrators, and community service providers to plan for the long term consequences of mental health courts as a form of jail diversion.