Assessing the Effectiveness of Mental Health Courts in Reducing Recidivism: A Systematic Review with Meta-analysis

Abstract

Mental Health Courts (MHCs) are a type of treatment court created to divert offenders with mental illness away from incarceration and into community-based treatment. While research on the impact of MHCs on recidivism has produced mixed results, there is a need to determine whether MHCs are effective. In light of this need, and of public support for the balanced justice approach toward mentally ill offenders, this study aims to assess the impact of MHC participation on recidivism. As such, the current study is a systematic review and a meta-analysis which replicates a study conducted by Lowder and colleagues while incorporating modifications to the methodology to reflect the new Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to determine the effect of MHC participation on recidivism. Results from the 15 included studies show a significant reduction (42.46%) in recidivism for individuals who participated in MHC treatment program. Policy implications, in light of the MHC model’s reduction in recidivism and alignment with the ideals of balanced justice, are discussed.

Keywords:

• Balanced justice
• mental health courts
• meta-analysis
• recidivism
• treatment courts

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Notes

1 The Ten Essential Elements are as follows: 1) planning and administration; 2) target population; 3) timely participant identification and linkage to services; 4) terms of participation; 5) informed choice; 6) treatment supports and services; 7) confidentiality; 8) court team; 9) monitoring adherence to court requirements; and 10) sustainability.

2 We thank the anonymous reviewer who suggested the time variability issue in our results. In addition, we are appreciative of this reviewer’s notion the outlier study may have a longer follow-up period influencing the recidivism rate. We did attempt to perform the moderator analysis, but we did not feel these results wouldn’t be anything by tentative at best due to so few studies in our pool. They are available from the third author on request. In actuality, the outlier study has a follow-up period consistent with the majority of the other studies included in this study.