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Effectiveness of a Mental Health Court in Reducing Criminal Recidivism and Violence

NCJ Number
American Journal of Psychiatry Volume: 164 Issue: 9 Dated: September 2007 Pages: 1395-1403
Dale E. McNiel ; Renée L. Binder
Date Published
September 2007
9 pages

In this paper, the authors describe their comparison of the criminal justice outcomes of individuals who entered the San Francisco mental health court during its first 22 months of operation with outcomes of others who were concurrently potentially eligible for consideration for selection into the mental health court; they describe their methodology and study population, statistical analysis and intent-to-treat analysis, and discuss their research findings.


In response to the large-scale involvement of people with mental disorders in the criminal justice system, many communities have recently created specialized mental health courts in. However, little research has been done to evaluate the criminal justice outcomes of such courts. This study evaluated whether a mental health court can reduce the risk of recidivism and violence by people with mental disorders who have been arrested. The authors used a retrospective observational design to compare the occurrence of new criminal charges for 170 people who entered a mental health court after arrest and 8,067 other adults with mental disorders who were booked into an urban county jail after arrest during the same interval. A matching strategy based on propensity scores was used to adjust analyses for nonrandom selection into mental health court. Propensity-weighted Cox regression analysis, controlling for other potential confounding variables (demographic characteristics, clinical variables, and criminal history), showed that participation in the mental health court program was associated with longer time without any new criminal charges or new charges for violent crimes. Successful completion of the mental health court program was associated with maintenance of reductions in recidivism and violence after graduates were no longer under supervision of the mental health court. The results indicate that a mental health court can reduce recidivism and violence by people with mental disorders who are involved in the criminal justice system. Publisher Abstract Provided