Stopping the Revolving Door: Effectiveness of Mental Health Court in Reducing Recidivism by Mentally Ill Offenders



Joye C. Anestis, Ph.D.; Joyce L. Carbonell, Ph.D.

Psychiatric Services 2014; doi: 10.1176/

June 02, 2014



Objectives  This study compared recidivism outcomes among criminal offenders with mental illness who were assigned to a mental health court (MHC) or a traditional criminal court. It also explored potential differences in outcomes between subgroups of offenders, including felony and misdemeanor offenders and violent and nonviolent offenders.

Methods  Data were obtained from court databases. Offenders in the MHC (N=198) and the traditional criminal court (N=198) were matched by propensity scores and followed for 12 months after the index offense. Data for the 12 months preceding the index offense were obtained for MHC participants. Intent-to-treat analyses were conducted, using both between-group and within-subjects designs.

Results  After control for covariates, logistic and Cox regressions indicated that MHC assignment predicted a lower overall rate of recidivism and longer time to rearrest for a new charge compared with assignment to traditional court. The groups did not significantly differ on the severity of the offense associated with rearrest. The findings largely held for felony, misdemeanor, violent, and nonviolent offenders, with the exception of analyses involving time to rearrest for violent offenders. Within-subjects analyses suggested that after MHC participation, there were improvements in occurrence of rearrest and time to rearrest but a tendency for rearrest to be associated with more severe offenses. Within the MHC group, recidivism outcomes did not significantly differ by class of offense.

Conclusions  The results suggest that an MHC can be effective in reducing recidivism among offenders with mental illness and also indicate that persons who commit more severe offenses may be appropriate candidates for MHC.






Human Services and Justice Coordinating Committee