Effect of behavioral health services and neighborhood disadvantages on recidivism: a comparison of mental health court and traditional court participants

Abstract

Objectives: This study investigates the impact of behavioral health services and neighborhood disadvantage on recidivism among offenders with mental illness in mental health courts (MHCs) and in traditional courts. Although treatment is believed to lead to reduced recidivism for offenders with mental illness, little research has been conducted with MHC participants. Furthermore, neighborhood disadvantages are known to influence recidivism generally, but environmental factors have not been examined in the MHC context. Methods: Data from the MacArthur MHC study were analyzed including 741 offenders with mental illness. Multilevel negative binomial regression was used to investigate individual and neighborhood level variances on recidivism and to control for the over-dispersion data. Neighborhood disadvantage data were obtained from the American Community Survey linked with residential data from participants. Results: MHC participants received more behavioral health services of all types than the treatment as usual (TAU) group with the exception of substance abuse case management. However, MHC participants lived in the more disadvantaged neighborhoods compared to the TAU group. MHC participants receiving substance abuse therapy were more likely to be arrested compared to the MHC participants without this therapy. A significant effect of neighborhood disadvantage on arrests was found across all study models. Conclusions: Professionals should recognize the importance of issues related to treatment-related variables and neighborhood disadvantages to develop, provide, and implement innovative interventions for offenders with mental illness. Understanding behavioral health services and neighborhood disadvantage associated with recidivism can help to more efficiently target research, practice, and policy for offenders with mental illness.