Improving the Impacts of Mental Health Courts

Keeping people with severe mental illnesses out of the criminal justice system is a pressing public health and public safety issue facing many communities today. Mental health courts (MHCs) have proliferated rapidly as a jail diversion strategy for persons with severe mental illnesses; however, low graduation rates and poor outcomes have been linked to substance use and limited service engagement. MHCs must combine judicial leverages with evidence-based interventions proven to address service engagement and substance use. A promising intervention for MHCs is dual diagnosis motivational interviewing (DDMI) – an adaptation of Motivational Interviewing for persons with psychiatric and substance use disorders – however, there have been no randomized trials of DDMI in MHC settings. More information is needed about combining clinical interventions with judicial interventions such as MHCs in a rigorous randomized clinical trial design. This presentation reports preliminary findings from a recent NIMH-funded feasibility study of a randomized trial of DDMI in a MHC. Barriers and facilitators to implementing DDMI and conducting a RCT in a MHC will be discussed, and study sample characteristics and preliminary outcomes will be presented. Adding clinical interventions to MHC judicial interventions will provide a new context for addressing engagement and substance use among thousands of justice-involved persons with severe mental illnesses. With over 300 MHCs across the country this research has the potential to have a broad public health and public safety impact. Implications for practice, policy and research will be discussed.