Multidimensional Evaluation of a Mental Health Court: Adherence to the Risk-Need-Responsivity Model

The current study examined the impact of a mental health court (MHC) on mental health recovery, criminogenic needs, and recidivism in a sample of 196 community-based offenders with mental illness. Using a pre-post design, mental health recovery and criminogenic needs were assessed at the time of MHC referral and discharge. File records were reviewed to score the Level of Service/Risk-Need Responsivity instrument (Andrews, Bonta, & Wormith, 2008) to capture criminogenic needs, and a coding guide was used to extract mental health recovery information at each time point. Only mental health recovery data were available at 12 months post-MHC involvement. Recidivism (i.e., charges) was recorded from police records over an average follow-up period of 40.67 months post-MHC discharge. Case management adherence to the Risk-Need-Responsivity (RNR) model of offender case management was also examined. Small but significant improvements were found for criminogenic needs and some indicators of mental health recovery for MHC completers relative to participants who were prematurely discharged or referred but not admitted to the program. MHC completers had a similar rate of general recidivism (28.6%) to cases not admitted to MHC and managed by the traditional criminal justice system (32.6%). However, MHC case plans only moderately adhered to the RNR model. Implications of these results suggest that the RNR model may be an effective case management approach for MHCs to assist with decision-making regarding admission, supervision intensity, and intervention targets, and that interventions in MHC contexts should attend to both criminogenic and mental health needs.