Mental Health Courts Show Potential

Mental health courts use different approaches to ensure compliance with mandated community treatment. Some courts require a guilty plea or another stipulation to the arrest charge.3 According to Steadman, individuals are usually required to plead guilty, and many courts then use a probation model to supervise the person in the community.

However, in some instances they deferred prosecution and the charges are dropped after the person completes the required term of treatment. However, Boothroyd noted that if defendants do not comply with MHC requirements, they may face sanctions including jail time.

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In one study, Steadman and colleagues evaluated individuals diagnosed with a mental health illness prior to being referred to an MHC, and then followed these patients for 18 months after being seen in one of four MHCs in various locations around the country. The investigators found both fewer arrests and jail days among those involved with an MHC.4

“MHCs tend to be successful. By and large, if you look at the time that the person was under court supervision and then after supervision — one or two years — they tend to have fewer arrests and fewer jail days than prior to being supervised by the court. Their symptoms somewhat reduce and functioning increases,” Steadman said.

However, Boothroyd and colleagues found no significant difference in a defendants’ clinical status between those with mental health illness addressed in MHC versus those seen in traditional court system, but explains that this study offers only preliminary data.

Boothroyd also noted that although MHCs increase patient access to mental health services, the courts have no control over the type and quality of care patients receive. He added that the lack of symptom improvement may have more to do with the chronic nature of the patients; mental health disorder and the adequacy of the public mental health system, rather than the effectiveness of the MHC in meeting the court’s articulated goals.5


Steadman believes it is important to recognize that candidates for enrolling in a MHC should be dependent on community-based services that the court can access. There must be evidence-based practices available that match the enrollees’ profiles in order to be effective. Boothroyd also emphasizes that further studies on the quality of the treatment defendants receive after being referred to an MHC could offer additional insight.

Beth Gilbert is a freelance writer based in West Palm Beach, Florida. This article has been medically reviewed by Pat F. Bass III, MD, MS, MPH.


  1. Mental Health America. Position Statement 53: Mental Heath Courts. Available at: Accessed: March 20, 2015.
  2. Interview with Roger Boothroyd and the Substance Abuse and Mental Health Services Administration‘s (SAMHSA) GAINS Center for Behavioral Health and Justice transformation. Adult mental health treatment courts database. Available at: Accessed: March 20, 2015.
  3. Griffin P, et al. The use of criminal charges and sanctions in mental health courts. Psychiatric Services. 2002; 53 (10): 1285-1289.
  4. Steadman HJ, et al. Effect of mental health courts on arrests and jail days. Arch Gen Psychiatry. 2011; 68 (2):167-172.
  5. Boothroyd RA, et al. Clinical outcomes of defendants in mental health court. Psychiatric Services. 2005; 56 (7):829-834.