Mental Health Courts Reduce Recidivism Among Adults with Mental Illness

Mental Health Courts Reduce Recidivism Among Adults with Mental Illness

ARLINGTON, Va. — Mental health courts are effective in reducing the number of adults with mental illness returning to the justice system, according to a new meta-analysis published online today in Psychiatric Services in Advance.

People with mental illness are overrepresented in the U.S. criminal justice system. Mental health courts allow for diversion into community-based treatment, potentially reducing the high rates of repeat involvement with the criminal justice system. The number of mental health courts around the country has grown in the past two decades and there are now almost 350 in the U.S. according to the Substance Abuse and Mental Health Services Administration. These courts typically involve defendants voluntarily agreeing to community-based mental health treatment with judicial supervision. When they successfully complete the program, participants are provided reduced or dismissed charges.

Researchers from North Carolina State University in Raleigh, N.C, led by Evan M. Lowder, Ph.D., now with Indiana University, Indianapolis, sought to examine the effect of participation in mental health courts in criminal recidivism compared to traditional criminal processing. They identified and reviewed 17 studies published between 2004 and 2015 involving more than 16,000 participants. Recidivism was typically measured over a 12-month period and included arrest, charge, conviction and jail time.

They found the mental health court participation reduced the recidivism measures of charge and jail time but did not significantly affect arrest or conviction. However, the subset of studies that measured based on those completing mental health court participation, rather than those starting, showed stronger effects on recidivism, including arrest and conviction.

Lowder and colleagues note that “our finding supports the effectiveness of mental health courts in reducing recidivism but also highlight important direction for future research.” In particular, they note the need for research to help better understand the design and operation of mental health courts and which components contribute to better outcomes, including reduced recidivism.


The American Psychiatric Association is the oldest medical association in the country founded in 1844. The APA is also the largest psychiatric association in the world with more than 37,000 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment.

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