Mental health courts may work, but does it matter if they do?

Abstract

Mental health courts (MHCs) are an important judicial innovation and have become increasingly popular. As specialty therapeutic courts, the MHCs focus on accessing treatment for defendants who meet their eligibility criteria. An overarching question is whether these courts work. Another important question is whether it matters even if they do, given the sheer numbers of people with mental illnesses arrested each year in the United States and the comparatively small number of people that mental health court dockets reach. In addition, because the courts are considered boutique courts in many jurisdictions, they may be vulnerable to budget cuts that have affected many state court systems in the United States. Finally, because of long delays in some courts between identification of an individual as potentially eligible and the decision to admit the person to the court, MHCs may not be as expeditious as other forms of diversion in getting people with mental illnesses into treatment rather than deeper into the criminal justice system. At the same time, MHCs in general do appear to have a positive impact on access to care and future recidivism. As importantly, this chapter concludes that MHCs meet other aims that go beyond the number of people they affect. These include providing defendants with voice and a sense of fairness that too often eludes the criminal justice system. In addition, MHCs are consistent in their aims with the principles of recovery and self-determination that are at the heart of contemporary mental health treatment. Finally, MHCs, with other therapeutic courts such as drug courts, have kept a rehabilitative spirit alive in a criminal justice system that for years has been primarily punitive in its goals and orientation. Therefore, the question of whether these courts work should be reframed to include other values that go beyond the number of people actually served.