The Impact of Substance Arrests on the Efficacy of Mental Health Court
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There is ample evidence that Mental Health Courts (MHCs) are effective in reducing recidivism for participants who are mentally ill. This study will examine if MHCs are effective for the large number of clients with mental illness who abuse substances. Participants in Brevard County Florida’s Mental Health Court (N = 118) were examined for a history of substance arrests. Those with a substance history (n = 63) were compared to those without a substance history and examined for the outcome variables of days free before rearrest, severity of rearrest, and offense type (e.g., substance related, etc.). A history of substance arrests resulted in more rearrests for any offense at 1 year and more rearrests for a substance offense 3 years post-MHC, compared to participants without prior substance arrests. A survival analysis demonstrated that more MHC graduates without substance arrest history were able to remain arrest free in the community than those with substance arrest history. For those participants with a substance arrest history, graduating MHC was associated with less rearrests in general, less substance rearrests, and less severe rearrests than their non-graduating comparison group. Within the first 6 months of leaving MHC, the amount of substance arrests before they enter the program predicts the amount of substance offenses committed after they leave the program, and the association is much stronger in those who do not graduate MHC. Findings suggest that MHC has a significant impact even on those with co-occurring disorders. However, they are at greatest vulnerability to relapse with substances within the first 6 months after leaving MHC, suggesting greater substance-specific supports in the community for dually diagnosed participants may be beneficial.
KeywordsSubstance abuse Mental illness Mental health court Co-occurring disorders Recidivism
The authors would like to thank the FIT Forensic Clinical Research Team for their assistance. The assistance of Dr. Barry Hensel and Tanya Johnson at Circles of Care, Blaise Trettis, Wayne Holmes, and Judge Cathleen Clarke was essential to the completion of this project.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- Baillargeon, J., Penn, J. V., Knight, K., Harzke, A. J., Baillargeon, G., & Becker, E. A. (2009). Risk of reincarceration among prisoners with co-occurring severe mental illness and substance use disorders. Administration and Policy in Mental Health, 37(4), 367–374. https://doi.org/10.1007/s10488-009-0252-9.CrossRefGoogle Scholar
- Epperson, M. W., Wolff, N., Morgan, R. D., Fisher, W. H., Frueh, B. C., & Huening, J. (2014). Envisioning the next generation of behavioral health and criminal justice interventions. International Journal of Law and Psychiatry, 37(5), 427–438. https://doi.org/10.1016/j.ijlp.2014.02.015.CrossRefPubMedPubMedCentralGoogle Scholar
- Florida Legislature. (2018). Brevard county. Tallahassee, FL: Office of Economic and Demographic Research Retrieved from http://edr.state.fl.us/content/area-profiles/county/brevard.pdf. Accessed 20 July 2018.Google Scholar
- Gallagher, A. E., Anestis, J. C., Gottfried, E. D., & Carbonell, J. L. (2017). The effectiveness of a mental health court in reducing recidivism in individuals with severe mental illness and comorbid substance use disorder. Psychological Injury and Law, 11(2), 184–197. https://doi.org/10.1007/s12207-017-9307-5.CrossRefGoogle Scholar
- Kassambara, A., & Kosinski, M. (2019). Survminer: Drawing survival curves using ‘ggplot2’. R package version 0.4.4. https://CRAN.R-project.org/package=survminer.
- Maruca, A. T., & Shelton, D. (2017). A review of treatment programs for offenders with co-occurring addictive and mental disorders: Support for booster interventions. Journal for Evidence-based Practice in Correctional Health, 1(2) Retrieved from: https://opencommons.uconn.edu/jepch/vol1/iss2/1/. 13 July 2018.
- Steadman, H. J., Redlich, A. D., Callahan, L., Robbins, P. C., & Vesselinov, R. (2011). Effect of mental health courts on arrests and jail days: A multisite study. Archives of General Psychiatry, 68, 167–172. https://doi.org/10.1001/archgenpsychiatry.2010.134.CrossRefPubMedGoogle Scholar
- Therneau, T. (2015). _A package for survival analysis in S_. version 2.38, URL: https://CRAN.R-project.org/package=survival.
- Wilson, A. B., Draine, J., Barrenger, S., Hadley, T., & Evans Jr., A. (2014). Examining the impact of mental illness and substance use on time till re-incarceration in a county jail. Administration and Policy in Mental Health and Mental Health Services Research, 41(3), 293–301. doi: https://doi.org/10.1007/s10488-013-0467-7 CrossRefGoogle Scholar
- Winick, B. J. (2003). Therapeutic jurisprudence and problem solving courts. Fordham Urban Law Journal, 30(3), 1055–1090.Google Scholar