Clinical outcomes of defendants in mental health court.

ABSTRACT

OBJECTIVE: Mental health courts successfully divert defendants into treatment. However, few studies have examined whether this increased access to services positively affects client outcomes. This study compared changes in symptoms in a sample of defendants in Broward County mental health court with such changes in a comparison sample of defendants in a regular court. METHODS: Participants included 116 defendants from mental health court and 101 defendants from a magistrate court who were assessed one, four, and eight months after an initial court appearance by using the Brief Psychiatric Rating Scale (BPRS). Both administrative and self-report data were used to identify defendants who received treatment after their initial court appearance. Participants were included in our analysis if they had at least one follow-up interview. RESULTS: A total of 97 defendants from mental health court and 77 from the regular court were included in our analysis. Analyses of covariance performed on changes in BPRS scores revealed no significant main effects by type of court, receipt of treatment, or the interaction between type of court and receipt of treatment. CONCLUSIONS: Although mental health courts have been found to increase defendants' access to mental health services, they have little control over the type and quality of services that defendants receive. The fact that reductions in symptoms were not observed among defendants who received treatment in either court setting more likely reflects the chronic nature of their disorders and concerns about the adequacy of our public mental health system, rather than a failure of the mental health court.