Criminal Justice Policy Review

Mental health courts are relatively new to the scenes of therapeutic jurisprudence and problem-solving courts. Research is necessary to determine how to evaluate this unique subset of courts and their clients. This research uses a mixed methodology to develop grounded theories explaining the differences found in more successful courts whose jurisdiction saw a statistically significant decrease in crime rate after the mental health court was established and less successful courts that did not. Eleven Oklahoma-based mental health courts were researched. More successful courts prioritized intensive monitoring methods, multiple specially tailored treatment options, and additional program supports. More successful courts also used a diverse court team, emphasized proper program assessment, visibly divided compliant and noncompliant participants in court, and gave “tangible symbolic incentives.” The found successful theories were compared with the published Essential Elements of a Mental Health Court and Cesare Beccaria’s Essay on Crimes and Punishment for possible future validation efforts.

The effectiveness of juvenile drug courts is mixed, and several factors could account for these findings. The present study examines whether and why youth with co-occurring mental health problems may have worse outcomes in juvenile drug court than youth who only have issues with substance use. In a sample of youth in juvenile drug court, 328 youth with co-occurring mental and substance use disorders were compared with 336 youth with only substance use disorders. Youth with co-occurring mental health problems had significantly worse criminal justice outcomes than youth without mental health problems. These outcomes were explained, in part, by more frequent violations of the drug court requirements, and in particular, violations surrounding treatment noncompliance. Results suggest that juvenile drug courts—as they currently operate—may be unsuccessfully managing youth who present with co-occurring mental health and substance use problems. Implications for policy and practice are discussed.

We examine the extent to which the relationship between mental health and substance use problems and the risk of rearrest varies across race/ethnicity. Data from the Pathways to Desistance, a longitudinal study of serious adolescent offenders, are used to estimate the risk of rearrest over time. Results show that mental health (except for substance use) does little, above and beyond traditional criminogenic risk markers and control variables, to significantly increase or decrease the risk of rearrest, a finding that was largely replicated across race/ethnicity. Some evidence emerged that the mechanisms by which mental health/substance use disorders and criminogenic risk interact to affect risk of rearrest operated differently across race/ethnic groups. Mental health conditions may have some small relationship to rearrest, but this effect is dwarfed by other more powerful risk factors such as antisocial history. Research is needed assessing the conditions under which mental health is implicated in offending.

Nationally, well over half of juvenile justice-involved youth report behavioral health impairment. Although the juvenile justice system may be the first place a youth is screened for behavioral health problems, the system is often ill-prepared to properly treat these youth. In response to the growing number of youth entering the juvenile justice system with behavioral health issues and the lack of proper care in these facilities, many communities have developed diversion programs as an alternative to detention. The current study investigated Ohio’s Behavioral Health Juvenile Justice (BHJJ) program, a diversion program for juvenile justice-involved youth with behavioral health issues that provides evidence-and community-based behavioral health treatment. Results indicated BHJJ was effective at improving behavioral health outcomes, including general functioning and trauma symptomatology, and reducing future delinquency. Analyses also examined the variables that predicted successful treatment completion and future adjudications. Implications for juvenile justice programming and policy are discussed.