Program Goals
Mental health courts (MHCs) are postbooking jail diversion programs that aim to divert justice-involved individuals with serious mental illnesses out of the court system and into community-based treatment without jeopardizing public safety. The goal is to reduce program participants’ recidivism by enhancing access and use of treatment.
There are over 250 MHCs operating around the country (Steadman et al. 2011). Four major metropolitan areas that operate MHCs include San Francisco County (San Francisco), Calif.; Santa Clara County (San Jose), Calif.; Hennepin County (Minneapolis), Minn.; and Marion County (Indianapolis), Ind. These four MHCs were the focus of the MacArthur Mental Health Court Study (described below in the Evaluation Methodology).
Target Sites/Population
Although eligibility criteria vary by site, courts usually accept both felony and misdemeanor charges (with the general exclusion of violent crimes) and require an Axis I diagnosis (such as schizophrenia, bipolar disorder, and depression) to enroll. Participation in MHCs is voluntary. Eligible persons have the choice to participate in the MHC or keep their cases in regular criminal court processing.
Services Provided
MHCs use a similar model of other problem-solving courts, such as drug courts. One important feature of MHCs is the periodic status review hearings before the MHC judge. If eligible individuals agree to participate, they have an initial hearing before the MHC judge where they may enter a guilty plea and agree to the conditions established by the program as well as the disposition of the criminal charges. MHC participants are required to keep in frequent contact with the judge, their caseworkers, and community treatment staff by attending subsequent status hearings. The purpose of the hearings is to monitor compliance and keep the participants on track.
Another important feature of MHCs is the use of sanctions and incentives to ensure adherence to the conditions of the program, including treatment compliance and attendance at status hearings. Sanctions are generally used to enforce program conditions, and may range from a scolding from the judge to increased supervision to a jail sentence. Incentives allow participants to be rewarded for compliance, and may range from praise from the judge to gift cards to reduced supervision.
Most MHCs require treatment as a condition of enrollment. Participants in the MHCs may receive intensive services (such as inpatient stays at short-term psychiatric facilities, 24-hour residential care, and detox services) or therapeutic services (including community-based treatment and support services such as day treatment, individual and group therapy, medication management, and case management).
One important difference between MHCs and drug courts is the philosophy underlying both programs. MHCs use a recovery model, in which relapse is considered part of the treatment process, whereas drug courts use an abstinence (from drug and alcohol use) model (Callahan et al. 2013).
