Rearrest and Linkage to Mental Health Services Among Clients of the Clark County Mental Health Court Program

Regional Research Institute for Human Services, Portland State University, Oregon 97207, USA.
Psychiatric Services (Impact Factor: 2.41). 08/2005; 56(7):853-7. DOI: 10.1176/
Source: PubMed


This study examined rearrest and linkage to mental health services among 368 misdemeanants with severe and persistent mental illness who were served by the Clark County Mental Health Court (MHC). This court, established in April 2000, is based on the concepts of therapeutic jurisprudence. This study addressed the following questions about the effectiveness of the Clark County MHC: Did MHC clients receive more comprehensive mental health services? Did the MHC successfully reduce recidivism? Were there any client or program characteristics associated with recidivism?
A secondary analysis of use of mental health services and jail data for the MHC clients enrolled from April 2000 through April 2003 was conducted. The authors used a 12-month pre-post comparison design to determine whether MHC participants experienced reduced rearrest rates for new offenses, reduced probation violations, and increased mental health services 12 months postenrollment in the MHC compared with 12 months preenrollment.
The overall crime rate for MHC participants was reduced 4.0 times one year postenrollment in the MHC compared with one year preenrollment. One year postenrollment, 54 percent of participants had no arrests, and probation violations were reduced by 62 percent. The most significant factor in determining the success of MHC participants was graduation status from the MHC, with graduates 3.7 times less likely to reoffend compared with nongraduates.
The Clark County MHC successfully reduced rearrest rates for new criminal offenses and probation violations and provided the mental health support services to stabilize mental health consumers in the community.

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    • "Second, we explored associations between individual factors and changes in pre-program and post-program jail days among MHC participants. We found MHC graduation status to be associated with significantly greater reductions in jail days served before program entry to after program exit, which is consistent with findings of previous studies (Broner et al., 2009;Herinckx et al., 2005;Steadman et al., 2011). Again, however, the present study adds to this body of work with its focus on recidivism exclusively following exit from the MHC when participants were no longer receiving the treatment supports and monitoring inherent to the MHC that may buffer against recidivism. "
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    ABSTRACT: Over the past decade, Mental Health Courts (MHCs) have spread rapidly across the U.S. These courts aim to reduce recidivism among adults with mental illnesses through diversion into community-based treatment. Extant research suggests that MHCs can be effective in reducing recidivism, but also demonstrates that effectiveness varies as a function of characteristics of the participants (e.g., criminal history) and the program (e.g., coercion). Less is known regarding the extent to which process-related factors (e.g., length of participation, time between referral and receipt of services) impact effectiveness. Prior research also is limited by a focus on recidivism during MHC as opposed to postexit. To address these knowledge gaps, we examined recidivism 1 year postexit for a group of MHC participants (n = 57) and offenders receiving treatment as usual (TAU; n = 40), total N = 97. We also investigated the influence of individual characteristics and process factors on changes in jail days 1 year preentry to 1 year postexit for MHC participants. Overall, results provide some evidence supporting the effectiveness of MHCs. MHC participants had significantly fewer jail days, but not charges or convictions, relative to TAU participants. Among MHC participants, graduation from the MHC, presence of co-occurring substance use, and longer length of MHC participation were associated with greater reductions in jail days. Other process factors were unrelated to reductions in recidivism. Findings suggest that MHCs may be particularly effective for high-risk participants and that time spent in a MHC has positive effects on recidivism, regardless of graduation status. (PsycINFO Database Record
    No preview · Article · Nov 2015 · Law and Human Behavior
    • " cases who only partially complete MHC, but this level of recovery was similar to that found for nonstarters. It should be noted, however, that a direct causal relationship between MHC involvement and mental health recovery is difficult to establish because offenders with better functioning likely had a greater chance of completing the MHC program.Herinckx et al. (2005)reported that MHC participants used fewer hours of crisis services and inpatient treatment. Similarly, for cases in the current study with a recorded history of mental health crisis service utilization, mental health–related emergency room visits decreased over time. For MHC completers, their use decreased by the second and third assessm"
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    ABSTRACT: The current study examined the impact of a mental health court (MHC) on mental health recovery, criminogenic needs, and recidivism in a sample of 196 community-based offenders with mental illness. Using a pre-post design, mental health recovery and criminogenic needs were assessed at the time of MHC referral and discharge. File records were reviewed to score the Level of Service/Risk-Need-Responsivity instrument (Andrews, Bonta, & Wormith, 2008) to capture criminogenic needs, and a coding guide was used to extract mental health recovery information at each time point. Only mental health recovery data were available at 12 months post-MHC involvement. Recidivism (i.e., charges) was recorded from police records over an average follow-up period of 40.67 months post-MHC discharge. Case management adherence to the Risk-Need-Responsivity (RNR) model of offender case management was also examined. Small but significant improvements were found for criminogenic needs and some indicators of mental health recovery for MHC completers relative to participants who were prematurely discharged or referred but not admitted to the program. MHC completers had a similar rate of general recidivism (28.6%) to cases not admitted to MHC and managed by the traditional criminal justice system (32.6%). However, MHC case plans only moderately adhered to the RNR model. Implications of these results suggest that the RNR model may be an effective case management approach for MHCs to assist with decision-making regarding admission, supervision intensity, and intervention targets, and that interventions in MHC contexts should attend to both criminogenic and mental health needs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    No preview · Article · May 2015 · Law and Human Behavior
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    • "e who have been neglected by the mental health system ( 2003 , p . 7 ) . No MHC study has focused specifically on the rela - tionship between target arrest type and outcomes . Many evaluations have examined MHCs that do not accept defendants with a felony charge ( Boothroyd et al . 2003 ; Christy et al . 2005 ; Dirks - Linhorst and Linhorst 2012 ; Herinckx et al . 2005 ; Hiday et al . 2013 ; Trupin and Richards 2003 ) , while others did not include target arrest as a covariate ( Cosden et al . 2003 , 2005 ; Frailing 2010 ) . 1 Only two studies have included a measure of target arrest charge type in predicting recidivism ( Burns et al . 2013 ; 1 Moore and Hiday ( 2006 ) used charge type to create a sev"
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    ABSTRACT: Using a statewide database of mental health court (MHC) defendants, this study examines criminal justice outcomes by target arrest offense type. Findings suggest that defendants with a felony are less likely to complete MHC but those who do are at no greater risk of recidivism post-exit than those with a misdemeanor. In terms of jail days, both completers and noncompleters with a felony had reductions in jail days; however, misdemeanor defendants, especially those who did not complete MHC, had increases. We discuss why MHC supervision may sometimes have a negative effect and offer recommendations on how courts might modify supervision.
    Full-text · Article · Jun 2014 · Administration and Policy in Mental Health and Mental Health Services Research
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