In light of the increasing number of mentally ill inmates in the criminal justice system, felony mental health courts aim to de-criminalize these individuals and link them to appropriate types of treatment within the community. Few studies have investigated the successful linkage of community-based treatment among felony mental health court participants. More specifically, there is an absence of research on the efficacy of pharmacotherapy on recidivism status among felony mental health court defendants. This retrospective study used archival data to determine if receiving pharmacotherapy will increase duration of time between arrests and keep felony mental health court participants out of the criminal justice system longer. The study also aimed to investigate if psychotropic medication use helped to reduce the risk of violent arrests among those participating in the felony mental health program. Lastly, it evaluated whether drugs from specific classes had more of an effect on recidivism status than others. Cox regression analyses, with propensity score adjustments, were used to determine if psychotropic medication keeps felony mental health court participants out of the criminal justice system longer. Cox regression analysis was also used to determine if specific drugs from different classes had more of an effect on time to re-arrest than others. Lastly, a binary logistic regression, with propensity score adjustments, was used to determine if psychotropic medication helped to reduce the risk of future violent offenses after entry into the FMHC program. All analyses included covariates to control for any potentially confounding factors to the outcome. The study yielded non-significant results when testing whether or not the use of psychotropic medication had an impact on the time to re-arrest, and on risks of future violent offenses.

Mental health courts (MHCs) are part of an umbrella of specialty courts in which court officials, law enforcement, and treatment providers work together to seek alternative solutions to failed traditional approaches to justice. Researchers investigating MHCs indicated that the courts may be helpful in reducing recidivism and introducing offenders with mental health disorders to treatment services. I used the qualitative method of phenomenology to understand the experiences of young adult Black male clients' perceptions of mental health treatment in MHCs. Twelve participants ranged in age from 21-40 years. The research team identified three themes -- (a) helpful treatment factors, (b) relational growth, (c) treatment barriers – and five subthemes: (a) internal growth, (b) relational growth, (c) behavioral growth, (d) factors of marginalization, and (e) interpersonal barriers. Meaning pertaining to findings and implications for research and practice are discussed.

In this thesis I investigate how the Canadian criminal justice system handles persons with mental disorders who come into conflict with the law. Through an in-depth examination of the Kitchener Mental Health Court this research explores the legal concept of diversion. Diversion is a voluntary option for individuals accused of minor offences. Its main objective is to function as a positive intervention. Offenders who participate in diversionary programs avoid a criminal record but are still held accountable for their criminal behavior. Diversion programs lessen the burden on the criminal justice system by decreasing the volume of caseloads in the courts via diverting individuals away from incarceration through alternative measures. The goal of this study is to uncover the processes involved in diverting offenders away from incarceration and into appropriate mental health treatment. Two theoretical frameworks applicable to mental health courts include the medical model and therapeutic jurisprudence. The thesis explores the philosophies of mental health courts, the principles of sentencing, and the role of community support agencies in the location and provision of mental health treatment. This research includes a six-month observational study of the Kitchener Mental Health Court setting and five in-depth interviews with the Crown prosecutor, defense attorney, Canadian Mental Health Association Court Coordinator, Salvation Army representative, and a mother of one of the accused. The findings from this research suggest that mental health courts strongly adhere to the treatment ideology contained in the medical model and therapeutic jurisprudence. The Kitchener Mental Health Court demonstrates this through its empathetic, treatment-oriented approach towards offenders, language, and commitment to locate appropriate health care. This research also reveals the crucial role community support agencies play in directing individuals towards the necessary health care. But most especially, the evidence points to the role community support agencies play as key facilitators in the legal processes of mental health courts.

In this thesis I investigate how the Canadian criminal justice system handles persons with mental disorders who come into conflict with the law. Through an in-depth examination of the Kitchener Mental Health Court this research explores the legal concept of diversion. Diversion is a voluntary option for individuals accused of minor offences. Its main objective is to function as a positive intervention. Offenders who participate in diversionary programs avoid a criminal record but are still held accountable for their criminal behavior. Diversion programs lessen the burden on the criminal justice system by decreasing the volume of caseloads in the courts via diverting individuals away from incarceration through alternative measures. The goal of this study is to uncover the processes involved in diverting offenders away from incarceration and into appropriate mental health treatment. Two theoretical frameworks applicable to mental health courts include the medical model and therapeutic jurisprudence. The thesis explores the philosophies of mental health courts, the principles of sentencing, and the role of community support agencies in the location and provision of mental health treatment. This research includes a six-month observational study of the Kitchener Mental Health Court setting and five in-depth interviews with the Crown prosecutor, defense attorney, Canadian Mental Health Association Court Coordinator, Salvation Army representative, and a mother of one of the accused. The findings from this research suggest that mental health courts strongly adhere to the treatment ideology contained in the medical model and therapeutic jurisprudence. The Kitchener Mental Health Court demonstrates this through its empathetic, treatment-oriented approach towards offenders, language, and commitment to locate appropriate health care. This research also reveals the crucial role community support agencies play in directing individuals towards the necessary health care. But most especially, the evidence points to the role community support agencies play as key facilitators in the legal processes of mental health courts.

The present study examined felony mental health court and mental health probation used in conjunction and whether those on mental health probation had a reduced rate of rearrest and psychiatric hospitalization as compared to participants on regular probation or not on either form of probation. The research explored whether specific variables predicted a reduced rate of hospitalization and arrest among the participants on mental health probation. Results found mental health probationers did not significantly differ from the probationers in their rate of rearrest, and were rearrested more frequently then participants not on probation. Mental health probationers did not differ significantly from regular probationers or those without probation in psychiatric hospitalization frequency. Within the mental health probationers type of crime, presence of a violent crime, age, gender, education level, history of substance abuse, prescription of psychiatric medication, diagnosis, mental retardation and prior psychiatric hospitalizations did not predict arrest. The above variables also did not predict psychiatric hospitalization, with the exception of a history of psychiatric hospitalization which predicted a higher rate of hospitalization while on mental health probation. Factors influencing these results and limitations of the present study were offered.

The purpose of this research study is to understand the characteristics of the people arrested for felony charges and transferred into the Broward County Felony Mental Health Court (FMHC) program. This research project will review previously collected data on the subjects who participated in the FMHC program between January 2007 and September 2008, and who were diverted to a residential dual-diagnosis program. Problem-solving courts have been developed in many states as a way to effectively restore offenders and reduce recidivism (Stefan & Winick, 2005). The goal of mental health courts is to prevent criminal behavior and recidivism by accommodating necessary mental health services to those who need it. However, most offenders placed in a mental health program commit new violations or offenses. A frequent question that is raised when evaluating mental health courts is whether they are successful in allocating resources for mentally ill defendants, as well as whether jail diversion programs are effective in preventing recidivism or rehabilitating mentally ill offenders. The difficulty to find answers for those questions may be due to the diversity of each jurisdiction's population, complexity of mental illnesses and differences in each unique jail diversion program. Some reports state that in contrast to drug courts, current mental health courts seem to lack resources to assess the participation of services mandated (Steadman, Davidson & Brown, 2001.) In this current study, the data collected on the subjects is comprehensive and include criminal, family, trauma, abuse and psychiatric histories. The levels of compliance were taken from re-arrests records including new crimes and violations of probation for up to two years after entering the jail-diversion program. This study is seeking to investigate the relationship between recidivism and different diagnoses, types of trauma experienced as a child as well as trauma scales from the Trauma Symptom Inventory (TSI.) It is hypothesized that elevated scores on trauma scales as well as early exposure of abuse will be related to high recidivism among a subset of participants in the mental health court program.

No description available.

La désinstitutionnalisation des personnes aux prises avec des troubles de santé mentale dans les années 60 au Canada a eu comme conséquences de rendre ces personnes plus susceptibles de se retrouver à la rue faute de services et leurs contacts avec les autorités policières ont augmenté. Face à la surreprésentation de personnes atteintes de troubles mentaux dans le système de justice et la reconnaissance que le système de justice traditionnel n’est pas adapté pour ce type d’accusés, des tribunaux de santé mentale (TSM) commencent alors à émerger. Au Québec, le premier TSM à voir le jour est le Programme d’accompagnement justice et santé mentale (PAJ-SM) à la Cour municipale de Montréal en 2008. Des questions résident autour de l’efficacité de ces tribunaux dont l’achèvement aurait pour effet de réduire le risque de récidive des accusés. Le principal objectif de cette étude est de comprendre le lien entre les principes de la justice thérapeutique (JT) et l’achèvement des PAJ-SM. Pour ce faire, les données ont été collectées à partir de 516 dossiers de procureurs dans six PAJ-SM différents. Des dimensions importantes de la JT souvent exclues d’autres études telles que les équipes multidisciplinaires, le fonctionnement du tribunal et les traitements ou services reçus par l’accusé ont été mesurées avec une régression logistique et des arbres décisionnels tout en tenant compte des caractéristiques des participants et des programmes qui peuvent influencer l’achèvement comme les données sociodémographiques, les diagnostics, les infractions, l’imposition de conditions de la cour et les évènements de vie qui ponctuent la trajectoire judiciaire des participants. Les résultats des analyses de la régression logistique et des arbres décisionnels indiquent que les participants qui utilisent des services médicaux ou psychosociaux, des services de la vie quotidienne et des services spécialisés, lors que leur participation au PAJ-SM, ont de plus grandes probabilités de compléter le programme. Aussi, ils ont de plus grandes probabilités de compléter le PAJ-SM, s’ils ont dans leur plan d’action l’objectif d’arrêter ou de diminuer leur consommation de substance et qu’ils ont de plus longs délais entre leurs audiences. / The deinstitutionalization of people with mental health problems in the 1960s in Canada made these people more likely to end up on the streets due to lack of services and their contact with the police authorities increased. Faced with the overrepresentation of people with mental disorders in the justice system and the recognition that the traditional justice system is not suitable for this type of defendant, mental health courts (MHC) then began to emerge. In Quebec, the first MHC to be created was the Programme d’accompagnement justice et santé mentale (PAJ-SM) at the Municipal Court of Montreal in 2008. Questions reside around the efficiency of its courts, the completion of which would reduce the risk of recidivism of the accused. The main objective of this study is to understand the relationship between the principles of therapeutic justice (TJ) and the completion of PAJ-SM. To this end, data were collected from 516 prosecutors’ files in six different PAJ-SM. Important dimensions of TJ often excluded from other studies, such as multidisciplinary teams, court functioning and treatments or services received by the accused, were measured with logistic regression and decision trees, while taking into account participant and program characteristics that may influence completion, such as sociodemographics, diagnoses, offenses, imposition of court conditions and life events that punctuate participants' judicial trajectory. The results of the logistic regression and decision tree analyses indicate that participants who use medical, psychosocial, daily living and specialized services during their participation in the PAJ-SM have a higher probability of completing the program. They are also more likely to complete the PAJ-SM if their action plan includes the objective of stopping or reducing their substance use, and if they have a longer delay between hearings.

Mental illness that affects an accused’s fitness to stand trial is an ill-explored topic in the South African criminal justice system. The necessity to explore this topic is motivated by the increasing number of persons with mental illness moving into the criminal justice systems in South Africa, Canada, and the United States of America. An accused’s fitness to stand trial is assessed once concern about his ability to follow the proceedings, or give proper instructions to his legal representative, is in doubt. The assessment is conducted in the forensic system where the vastly different fields of law and psychiatry meet. The South African forensic system is plagued with resources and skills shortages. These inadequacies cause delays in resolving pre-trial issues for an accused in respect of whom fitness is at issue. The accused is oftentimes detained in a correctional facility awaiting fitness assessment for anything between three months to two years. Generally, detention in a correctional facility has a negative effect on the mental state of a person with a mental illness. The logistics of fitness assessments differ between the three jurisdictions referred to above. However, the threshold for fitness in these jurisdictions is relatively low, with the result that the majority of accused persons sent for fitness assessments are found fit to stand trial. Such a finding does not imply that the accused is not mentally ill; it simply means that the illness does not affect his understanding of the court proceedings and that it does not influence his ability to communicate with his legal representative. An accused with a serious mental illness such as schizophrenia or major depression can, for example, be found fit to stand trial. After a fitness assessment, a court may either find an accused fit to stand trial or unfit to stand trial. The fact that many persons found fit to stand trial have a mental illness suggests that there is a third category on the fitness continuum that must be acknowledged, namely, fit but mentally ill accused persons. No alternatives to traditional prosecution currently exist in South Africa for this third group of accused persons despite the fact that their situation in the criminal justice system calls for a therapeutic response. The South African legislative framework that regulates fitness assessments and the processes associated therewith are not without challenges. The assessment practices have recently been under scrutiny by the Constitutional court, which judgment changed the position for the accused found unfit to stand trial. The position of the fit but mentally ill accused remains unregulated. The Canadian and American criminal justice systems have implemented diversion programmes for fit but mentally ill accused persons in the form of Mental Health Courts. The underlying principle of a Mental Health Court is therapeutic jurisprudence. Therapeutic jurisprudence evaluates the impact of the law on those in conflict with it. It promotes the inclusion of expertise from other disciplines to improve the effectiveness of the law in a particular set of circumstances. Many South African scholars acknowledge the need for mental health expertise in the criminal justice system, and suggestions have been made for the diversion of mentally ill accused persons charged with minor offences. Those above notwithstanding, no formal diversion programmes exist in South Africa for the fit but mentally ill accused. This research investigates the Mental Health Court as a therapeutic response to the mentally ill accused in the South African criminal justice system. The Mental Health Court models as employed in Canada and the United States of America are studied to identify elements thereof that can be employed in the South African context to provide an effective alternative to traditional prosecution for the mentally ill accused. The Toronto Mental Health Court is studied in the Canadian context as a court that is not a diversion programme as such but has a diversion component attached to it. Diversion in Canada is reserved for those charged with less serious offences, and only these accused persons are allowed into the diversion component of the Mental Health Court. However, the Canadian Mental Health Court assists those who do not qualify for diversion but who need the specialised skills of the Mental Health Court for purposes of, for example, a bail application. The Brooklyn Mental Health Court in the United States of America is investigated as a model that constitutes a complete diversion programme and considers diversion of accused persons charged with more serious offences. The unique structure and procedure of each of these Mental Health Courts are investigated with due consideration to the eligibility criteria of each and the sanctions employed for non-compliance of the court-monitored treatment programmes. Further, the successes and challenges of each model are highlighted. Finally, a proposal is made for a Mental Health Court model mindful of the uniquely South African factors that have to be taken into account when building such a model. Amendments to the existing legislative framework are proposed to incorporate a Mental Health Court as a therapeutic response to mentally ill accused persons in the South African criminal justice system. / Criminal and Procedural Law

This thesis examines how military members and veterans with Operational Stress Injuries are treated by Canadian justice systems. It suggests a correlation between mental injuries sustained on operations by military personnel and propensities for military and societal misconduct. By comparing civilian and military processes with American justice counterparts, a plan to improve the existing Canadian legal landscape is proposed. Using an analysis of the underlying philosophy and purpose of military justice, a problem solving diversionary court is recommended, along with legislative and policy amendments. The use of a consent-based “Treatment Standing Court Martial” would place military justice officials parallel to civilian justice alternative measures programs, and in a better position to break the cycle of recidivism among veterans by addressing root causes. Education to reduce stigma along with military-civilian partnerships are also advocated to enhance the detection of mental illness and to foster early treatment for military personnel and veterans. The overall goals of the work include: reducing recidivism, improving operational efficiency and taking care of military members, veterans and their families.