What's the verdict? an examination of the evidence for mental health treatment courts

Rising incarceration rates of persons with serious mental illness represent a major public health concern within the United States. Instead of providing needed treatment and resources, evidence suggests that jails and prisons typically exacerbate symptoms of mental illness. Mental health courts arose as one response to this concern, and typically divert an individual with mental illness away from the criminal justice system in return for participation in monitored mental health treatment. However, the proliferation of mental health courts has grossly outpaced research on their effectiveness. A review of the literature was conducted, yielding more than 20 studies from either peer-reviewed journals or county evaluation reports. The ability of mental health courts to: 1) improve psychiatric symptoms, 2) connect individuals with behavioral health services, 3) improve overall quality of life, and 4) reduce recidivism rates were explored. A majority of available research focuses primarily on a reduction in recidivism rates, ignoring other important therapeutic outcomes. Of the reviewed studies, nearly two-thirds reported positive outcomes related to a reduction in recidivism rates. Importantly, however, data on additional therapeutic outcomes were largely absent from mental health court research. At the present time, mental health courts represent an emerging practice, but have not yet reached the level of an evidence-based model. Limitations of existing mental health court research, inherent challenges of evaluating mental health courts, and recommendations for future mental health court evaluations are presented to guide future program development and evaluation of mental health courts.