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An increased recognition that the United States criminal justice structure was being overwhelmed with people suffering from psychological diseases during the 1980s triggered the need of alternative incarceration approaches. The initial problem-solving courts for offenders diagnosed with mental health illnesses was developed in 1980 in Marion County, Florida (Fister, 2015). This court offered service to persons with severe mental health diseases facing minor felony charges or non-aggressive misdemeanors. The Los Angeles County Department of Mental Health later developed a forensic mental health court (MHC) diversion program that offered consultation services to courts on the management of criminals with psychiatric illnesses (Fister, 2015). The initial MHC was developed in 1997 in Broward County, Florida, following the drug courts incapacity to address mental health needs among clients with psychological issues such as recurrent substance use (Maschi & Leibowitz, 2018). The paper provides an in-depth discussion about the rationale for the courts inception and describes facts associated with MHCs.
The Rationale for the Court
The U.S criminal justice structure has long identified the incidence of mental health problems in the corrections populace. According to a survey by the U.S Bureau of Justice Statistics, approximately sixty-two and fifty percent of jail and prison inmates respectively reported suffering from a psychiatric disorder at a particular period (Lowder et al., 2017). Mental health courts were created to curb or control psychological illnesses among justice-involved persons. It was established following the recognition that the regions drug court was deficient in the essential mental health services needed by candidates with recurring substance use and psychological illnesses. These courts underscore rehabilitation as opposed to penalties to foster resistance from offensive behavior. The overall goal of the mental health courts is to minimize the rates of incarceration.
MHC and Client Selection
Mental health courts have multiple defining features, including
- Specialized case dockets typified by defendants with psychological illness;
- A non-adversarial and collaborative team consisting of a mental health representative, defense and prosecuting attorneys, and a judge (Maschi & Leibowitz, 2018);
- A connection to a local psychiatric health system;
- Some types of compliance or adherence monitoring, with penalties for non-conformance.
Some arrested people with psychological illnesses are provided the option or choice of participating in the MHC in lieu of conventional court processing or procedures, plead innocence or guilt, and sentenced if found culpable (Canada & Ray, 2016). Mental health courts clients may forgo delinquent processing altogether, receive an unconventional or alternative convenient sentence for engaging and finishing the MHC program, or undergo malefactor processing but go without sentencing.
The eligibility criteria for MHCs usually require that the offenders have a mental disorder, which may or may not be identified as persistent, chronic, or severe and non-violent criminal charges, commonly categorized as misdemeanors. The screening, identification, and recruitment of these cases is less clear. Prospective individuals may be referred to the MHC by a prosecutor, police officer, jail personnel, judge, treatment provider, family member, or defense attorney. They might be formally screened by the case coordinator or court team with psychiatric health training with or without the help of a mental health professional (Lowder et al., 2017). The formalization of data utilized to ascertain eligibility may be done via screening protocol, or it can be informal and particular or specific to an individual or team. Even after being considered a suitable candidate for the MHC, issues such as conviction, motivation, treatability, and support from the defense attorney and victims may independently influence clients recruitment and selection. The convergence of all these aspects during the selection procedure predicts the differences in client pools among mental health courts.
Components and Goals of MHCs
The Council of State Governments Justice Center developed ten crucial MHC elements that promote best practices. They include
- Administration and planning. This feature incorporates stakeholders who represent the criminal justice structure, SUD therapy practitioners, psychiatric health treatment professionals, and others who guide or direct the courts planning;
- Target populace. It underscores the eligibility criteria, which aims to address public safety using the courts therapy capacity and the connection between criminality and mental health;
- Timely identification and service linkage. At this stage, participants are distinguished, accepted, and redirected from incarceration;
- Informed decision. Offenders should be fully knowledgeable of the conditions for engagement and are offered legal counsel.
- Treatment services and supports. Clients are linked to individualized therapy services;
- Confidentiality. The clients legal and health data gathered during the treatment procedure ought to be protected.
- Court team. Proper training should be offered to the criminal justice team, treatment providers, and mental health experts;
- Monitoring compliance to court mandates. Collaboration between court staff is crucial to ensure participants effective monitoring. According to Loong et al. (2016), they typically provide graduated sanctions and incentives;
- Sustainability. Information is often gathered and evaluated to gauge the effect of the court, facilitate the institutionalization of court procedures, and cultivate community support.
Problem-solving courts, for instance, MHCs, often recognize the importance of therapy coupled with rehabilitation amid the justice-involved populace, and case managers act as a liaison between probation officers and treatment providers. In this way, mental health courts prioritize a highly rehabilitative setting with less punitive sanctions. Establishing the successful termination of involvement in MHCs, according to Lowder et al. (2017), is difficult because overcoming a psychiatric condition varies significantly among individuals. Common MHC goals include improving the safety of the public, bettering the life quality of the people suffering from psychological illness, and minimizing corrections and court-related costs by diverting individuals from incarceration.
Some studies identify therapeutic jurisprudence as another specific goal and an integral component of MHCs. According to Canada and Ray (2016), therapeutic jurisprudence is an inquiry field that focuses on the notion that legal procedures, rules, and the department of licit actors may have corrective impacts for offenders. MHCs implement the aforementioned practice by reducing punishment, i.e., anti-treatment consequences, and increasing room for self-actualization and empowerment.
Effectiveness of Mental Health Courts as an ATI/Treatment Court
Despite the increasing prominence of MHCs in the U.S over the past decade, there is no definitive proof of their efficacy. Studies on this topic associate MHCs with positive outcomes (Maschi & Leibowitz, 2018). However, other surveys reveal mixed findings prospectively due to the variations in outcome computations and the rigorous nature of the selected methodologies.
Measuring Recidivism
Since MHCs overall objective is to minimize criminality among individuals suffering from psychiatric health diseases and elevate the safety of the public, recidivism is recognized as the favored measure for evaluating the programs efficacy. According to Lowder et al. (2017), two studies uncovered MHCs efficiency in reducing recidivism risk; however, this impact might only be modest. Another research involving nine Illinois MHCs revealed that fifty-three percent of the participants were arrested for misdemeanor or felony within three years following their MHC enrollment. Reverting outcomes related to MHCs may be synonymous with those of regulated probation. One research conducted in Illinois involving probation participants indicated that fifty-four percent were rearrested within four years after completing probation (Loong et al., 2016). These findings were also echoed by a review involving MHC candidates in Broward County. Both studies did not identify any statistically significant variation in first-year rearrest incidences between MHC and standard probation participants.
On the contrary, another research revealed that while both groupings experienced a decline in the yearly rearrest rate, the recorded decrease amid MHC participants were substantially significant. This phenomenon was common among MHC offenders who had attained high life quality scores and had finished the project (Fisler, 2015). An assessment of MHCs located in Michigan linked the successful completion of the program and high life quality scores with a reduced probability of participants involvement in new offenses. The aforementioned finding was supported by another analysis that exhibited that individuals who did not finish their MHC project were 3.7 times more likely to revert to their old ways than the people who did (Loong et al., 2016). A survey by Canada and Ray (2016) further revealed that MHC participation triggered individuals engagement in mental health and life, improved relations, sobriety, and better psychiatric stability. MHC offenders with specific criminal histories, such as driving-related crimes, trespassing, and drug and alcohol use, are highly prone to recidivism compared to others.
Conclusion
The first MHC was established following the recognition that the regions drug court was deficient in the essential mental health services needed by candidates with recurring substance use and psychological illnesses. The current research body on MHCs reveals their significance in yielding positive outcomes, both in enhancing participants life quality and minimizing recidivism. Improving and reinforcing public safety through decreasing criminality is the primary mental health courts goal. Offenders with higher life quality scores and those who have completed the program successfully are unlikely to revert comparing to their counterparts.
References
Canada, K. E. & Ray, B. (2016). Mental health court participants perspectives of success: What key outcomes are we missing?International Journal of Forensic Mental Health, 15(4), 352361. Web.
Fisler, C. (2015). Towards a new understanding of mental health courts. The Judges Journal, 54(2), 813.
Lowder, E. M., Rade, C. B., & Desmarais, S. L. (2017). Effectiveness of mental health courts in reducing recidivism: A meta-analysis.Psychiatric Services, 69(1), 1522. Web.
Loong, D., Bonato, S., & Dewa, C. S. (2016). The effectiveness of mental health courts in reducing recidivism and police contact: A systematic review protocol.Systematic Reviews, 5, 123. Web.
Maschi, T., & Leibowitz, G. S. (Eds.). (2018). Forensic social work: Psychosocial and legal issues across diverse populations and settings (2nd ed.). Springer Publishing.
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