Who Succeeds in Jail Diversion Programs for Persons with Mental Illness? A Multi-Site Study
ABSTRACT This study examined how the characteristics of people with mental illness who are participants in post-booking jail diversion programs affect recidivism and time spent incarcerated. The study employed data from a multi-site, federally funded jail diversion initiative. A pre-post comparison design was used to compare experiences of arrest and days spent in jail of diverted individuals for the 12 months following enrollment with the 12 months prior to enrollment. Also compared were differences in 12-month public safety outcomes. Data were collected between February 2003 and August 2007. The findings suggest that people with mental illness who are diverted from jail to community-based services experience fewer arrests and jail days. Approximately half of the sample were never arrested during the 12 months following enrollment. The strongest differences between people who experienced reduced contact with the criminal justice system and people with unchanged or increased contact were found in measures of criminal history. The results suggest that services targeted to diverted individuals with mental illness should address public safety goals, not just those of public health.
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ABSTRACT: Background Based upon therapeutic justice principles, mental health courts use legal leverage to improve access and compliance to treatment for defendants who are mentally ill. Justice-involved women have a higher prevalence of mental illness than men, and it plays a greater role in their criminal behavior. Despite this, studies examining whether women respond differently than men to mental health courts are lacking. Study goals were to examine gender-related differences in mental health court participation, and in criminal justice, psychiatric and health-related outcomes. Methods This study utilized a quasi-experimental pre-posttest design without a control group. The data were abstracted from administrative records of Kalamazoo Community Mental Health and Substance Abuse agency, the county jail and both county hospitals, 2008 through 2011. Generalized estimating equation regression was used to assess gender-differences in pre-post program outcomes (jail days, psychiatric and medical hospitalization days, emergency department visits) for the 30 women and 63 men with a final mental health court disposition. Results Program-eligible females were more likely than males to become enrolled in mental health court. Otherwise they were similar on all measured program-participation characteristics: treatment compliance, WRAP participation and graduation rate. All participants showed significant reductions in emergency department visits, but women-completers had significantly steeper drops than males: from 6.7 emergency department visits to 1.3 for women, and from 4.1 to 2.4 for men. A similar gender pattern emerged with medical-hospitalization-days: from 2.2 medical hospital days down to 0.1 for women, and from 0.9 days up to 1.8 for men. While women had fewer psychiatric hospitalization days than men regardless of program involvement (2.5 and 4.6, respectively), both genders experienced fewer days after MHRC compared to before. Women and men showed equal gains from successful program completion in reduced jail days. Conclusions Despite similar participation characteristics, findings point to greater health gains by female compared to male participants, and to lower overall psychiatric acuity. Mental-health-court participation was associated with decreased psychiatric hospitalization days and emergency department visits. Successful program completion correlated to fewer jail days for both women and men.12/2014; 2(1). DOI:10.1186/s40352-014-0012-0
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ABSTRACT: Study attrition is a problem in all community-based intervention studies using longitudinal research designs, but is compounded with hard to reach populations. High attrition poses threats to internal and external validity and may result in an inadequate sample size. The purpose of our study was to determine the characteristics associated with attrition. The study employed data from a cross-site evaluation of jail diversion programs. A self-report interview was conducted at baseline for 1,289 individuals. A 33% and 52% attrition rate was observed at the 6-month and 12-month follow-up interviews, respectively. The characteristics associated with loss to follow-up were male gender, part-time or full-time employment, drug offenses, jail days, baseline interview location, community supervision, and community geography. Knowing which individuals are more likely to attrit allows evaluators to develop targeted sampling strategies and participant engagement strategies.Criminal Justice and Behavior 05/2014; 41(6):772-790. DOI:10.1177/0093854813514580 · 1.71 Impact Factor
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ABSTRACT: Mental health court (MHC) research consistently finds that defendants who successfully complete and graduate from the court are less likely to recidivate than those who do not. However, research has not assessed what happens to these noncompleters once they are sent back to traditional court. Using follow-up data on six years of noncompleters from pre-adjudication MHC, we examine what happens to these defendants in traditional court. Findings suggest that 63.7% of defendants' charges were dismissed, 21.0% received probation, and 15.3% were sentenced to incarceration. We examine the time to disposition and differences in defendant characteristics and disposition outcome as well as the relationship between disposition and subsequent recidivism. Results suggest that more severe punishments in traditional court are associated with recidivism. Logistic regression analysis shows that defendants whose charges were dismissed in traditional court were less likely to recidivate than those who were sentenced to probation or incarceration. Our findings highlight the need for future MHC evaluations to consider traditional court outcomes and support trends towards post-adjudication courts. Copyright © 2015 John Wiley & Sons, Ltd.Behavioral Sciences & the Law 01/2015; DOI:10.1002/bsl.2163 · 0.96 Impact Factor