Improving the Impact of Mental Health Courts

Background/Purpose: Mental Health Courts 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. This presentation explores how Mental Health Courts might improve poor outcomes by combining judicial leverages with evidence-based interventions that address substance use and engagement with services. 

Methods: A study was conducted to assess the feasibility of: (i) implementing dual-diagnosis motivational interviewing in a mental health court; and (ii) implementing a randomized controlled trial in a mental health court setting.

Findings: Implementing Dual-Diagnosis Motivational Interviewing (DDMI) in a mental health court setting is feasible. Fidelity assessments and clinician ratings of DDMI implementation will be presented in addition to qualitative data collected from court staff about the implementation of the intervention. Implementing a Randomized Controlled Trial (RCT) of DDMI in a court setting is feasible. Recruitment and enrollment rates, follow-up rates, study enrollment rates and other metrics will be presented. Results from the RCT will be presented - the outcomes of court participants who received a court intake enhanced with DDMI will be compared to those who received a standard court intake.

Implications: Adding clinical interventions to Mental Health Courts will provide a new context for addressing engagement and substance use among justice-involved persons experiencing severe mental health symptoms.  With over 300 Mental Health Courts across the US, this research has the potential to have a broad public health and public safety impact. Implications for practice, policy and research will be discussed.