Mental health courts are popular in many communities, and it鈥檚 easy to understand why. Rather than sending someone who鈥檚 mentally ill to an overcrowded jail聽that is poorly equipped to manage his condition, mental health courts offer treatment and help with housing and other social services. The community saves on the cost of locking someone up and offenders get聽support聽to stay healthy聽and may have their charges expunged. Everybody wins, right?
Local judges, frustrated at seeing the same faces聽repeatedly, are often the driving force behind establishing a mental health court. Once established, the judges may dedicate a day or more a week to these cases. Programs vary widely, but they often oversee a team of mental health experts and social services case managers who refer participants to聽services available in the community. Offenders generally return to the court regularly聽for the judge to review their progress聽and offer聽encouragement or,聽if necessary, sanctions.
But research is still scanty on the courts鈥� effectiveness at addressing offenders鈥� mental health problems or discouraging聽offenders from relapsing into criminal behavior. And some聽experts are concerned that offenders who are charged with minor crimes would be better off staying out of the criminal justice system and instead just getting treatment.
The popularity of mental health courts also aligns with growing concerns about prison crowding and the ever increasing costs to taxpayers. Estimates vary, but up to two-thirds of people in jails and prisons had a mental health problem聽in the previous year, compared with 11 percent of the general population.聽Although inmates have a ,聽correctional institutions are generally not set up聽to provide treatment for mentally ill prisoners.
In Florida鈥檚 Miami-Dade County, Judge Steve Leifman presides in the and oversees the mental health court. The approach there to dealing with mentally ill offenders is multilayered, Leifman says. Many arrests are averted by a crisis intervention team of police who refer people to treatment before they鈥檙e booked. Offenders who are arrested and complete the mental health court program have a much lower recividism rate than their peers: 20 percent versus 72 percent.
鈥淭he key is to identify people and get them treatment earlier,鈥� Leifman says. To that end the program is now training teachers on how to identify signs and symptoms of mental illness in children.
that summarized聽research on聽mental health courts concluded that they seemed to be modestly effective at reducing recidivism, but it was unclear whether they had a positive effect on participants鈥� mental health.
These courts handle only a tiny fraction of cases dealing with mentally ill offenders, by some estimates 5 percent or less. Given their limited resources,聽it鈥檚 critical that mental health courts聽target the right people, generally those who are at highest risk for committing a new crime and who have serious mental illness, say experts.
From that perspective, the shift toward including people who are charged with more serious crimes and may be facing a sentence of several years makes sense.
鈥淭hat鈥檚 when you start to see real cost benefits [to the system] in that you鈥檙e averting real jail time,鈥� says Dr. Fred Osher, director of health systems and services policy at the Council of State Governments Justice Center, a nonprofit that consults on public safety issues.
As for the individuals themselves, if they鈥檙e facing just a few weeks or months behind bars for conviction of a minor crime, they may balk at enrolling in a program that requires them to return to court repeatedly for up to two years. On the other hand, if they鈥檙e facing five years in jail versus a one- to two-year supervised program with the mental health court, 鈥渢heir lawyer may say it鈥檚 a viable option,鈥� Osher says.
Some research suggests that offenders who have committed聽violent crimes may benefit more from mental health court than non-violent offenders, says KiDeuk Kim, a senior research associate at the Urban Institute鈥檚 Justice Policy Center.
鈥淭heir recividism rate was lower than non-violent participants,鈥� Kim says, referring to a in Brooklyn and the Bronx that he coauthored.
Not everyone is a fan of mental health courts.
鈥淚t鈥檚 an inefficient solution, and one that has costs that haven鈥檛 really been examined,鈥� says Ira Burnim, legal director at the Bazelon Center for Mental Health Law. 鈥淚t鈥檚 inefficient in the sense that these courts are doing the work of managing the process of engaging and working with the individual that the mental health system should be doing.鈥�
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