The Effect of Homelessness, Housing Type, Functioning, and Community Reintegration Supports on Mental Health Court Completion and Recidivism

Abstract

Although mental health court has been found to increase quality of life and functioning, it is unknown whether community stability indicators predict program completion and delay re-arrest for homeless versus non-homeless mental health court participants. Self-reported quality of life and social support, chart diagnosis, and administrative housing, services and criminal justice data were collected for 589 Bronx Mental Health Court participants for 12 months following diversion. Individuals who were homeless (n = 89) versus housed (n = 500) during the 12 months prior to diversion were compared to determine predictors of court graduation and re-arrest. Homeless status did not predict graduation or re-arrest, and quality of life, social support, functioning and housing type were not predictive of re-arrest. Housing instability negatively affected outcomes for both homeless and non-homeless individuals. An increase in functioning and a slight improvement in social support were predictive of successful graduation for homeless individuals, whereas a large increase in social support and lower functioning had a negative impact. In contrast, positive life satisfaction was predictive of successful graduation in non-homeless participants. Those who did not complete mental health court, whether homeless or not, were more likely to be re-arrested, particularly for felony and drug-related offenses than those who graduated. Mental health court was generally beneficial to mental health court participants. However, for those previously homeless, functioning and social support may play a unique and interconnected role in court graduations, whereas general life satisfaction may be a better indicator for program completion for non-homeless individuals.

KEYWORDS:

• Homeless
• mental health court
• diversion
• social support
• quality of life
• co-occurring mental and addictive disorders
• recidivism

This research was supported by the U.S. Department of Health and Human Services Substance Abuse Mental Health Services Administration Center for Substance Abuse Treatment, Grant Number TI16682. The views expressed are solely those of the authors and do not necessarily reflect the views of the funding agency.

The authors thank Elizabeth Tibaduiza, MA, and Renata Zablocka, MA, for data collection, and Charles Amhrein, PsyD, for providing detailed information on participants that served as the basis for the included case description.

Notes

^aMinus days in jail/prison and days absconded.

^bMinus days hospitalized or days in jail/prison.

^aThose who died, could not complete treatment for medical or serious psychiatric issues, or were still in treatment were not coded as having graduated or terminated.

^bTerminated for rearrest, absconding, treatment noncompliance, or dropout (opting for jail).

^cDrug-related charges and convictions include drug possession and drug sale.

^dCaution interpretation: numbers too small for statistical analyses; 2 homeless individuals and 1 non-homeless individual were convicted of violent charges.