The purpose of this research was to examine “who” was best served by a mental health court (MHC) by identifying the characteristics of participants that were predictive of six-month post opt-in program retention and non-recidivism. Participants were 148 available adults who had recently enrolled in 1 of 4 west coast MHCs, were diagnosed with an Axis I schizo-spectrum disorder, bipolar disorder, or major depression, were legally competent, and provided informed consent. This court-based exploratory study used structured in-person interviews to administer standardized measures to collect demographic, socioeconomic, criminal history, psychiatric, substance use/misuse, health, motivation to change, and therapeutic alliance characteristic data. Additional data were provided by the MHC study sites. Participants ranged in age from 18 to 64 (M = 36.56, SD = 11.81) and most had less than a high school education (M = 11.46, SD = 2.49). Participants were more typically male (61%), white (58%), unmarried (93%), unemployed (92%), had a prior felony (57%), and were diagnosed with schizophrenia (49%) and a comorbid substance use disorder (68%). At 6-month follow-up, 72% of the participants remained enrolled in MHC and 55% remained arrest-free. Results from chi-square and independent sample t-test analyses showed significant differences in the years of education, GAF scores, number of contacts with a mental health professional, and strength of therapeutic alliance with the MHC judge between retained and not retained participants. A significant logistic regression model identified that more years of education, a higher number of contacts with a mental health professional, and a stronger therapeutic alliance with the MHC judge were significant predictors of participants’ program retention. Additionally, significant differences were found between recidivating and non-recidivating participants’ age, ethnicity, education, income, housing, prior criminal history (e.g., prior charges, arrests, and jail days), GAF scores, BPRS scores, AUDIT scores, DAST scores, and comorbid substance use disorder. Another significant regression model identified being older, more educated, white, and having income other than SSI/SSDI were predictive of non-recidivism. MHC programs may use these findings to better assess potential participants, provide more targeted treatment and other related support services, and consider ways to strengthen their working alliance with participants. / text

The decision to establish a mental health court in Utah's First District was largely a political one prompted by the growing popularity of problem-solving courts throughout the country. Because this motivation was policy-driven and not needs-driven, the court was established without an ongoing data collection schedule. As a result, barring anecdotal evidence from program participants, the current impact of the court on two key goals-- reducing recidivism and increasing community-based treatment contact--is entirely unknown. The current study aims to provide a summative program evaluation of the first sixty-eight months of specialty court operation by (1) estimating basic demographic and clinical information about program referrals, participants, and graduates; and (2) measuring program effectiveness by examining between-group differences in key outcome measures (e.g., new charges, use of therapeutic services, time to rearrest, etc.) for those referrals who are accepted into the program as participants versus those referrals who are rejected from the program and sentenced to treatment-as-usual. Ideally, the current study will not only provide an evidence-based assessment of local practices at the current study site but will also empirically inform the greater community of mental health practitioners, researchers, and policymakers who are operating in smaller, more rural districts.

abstract: This dissertation explores the lives of women who are on the Severely Mentally Ill (SMI) caseload at Maricopa County Adult Probation in Arizona (The Phoenix metro region). The project focuses on three primary issues: (1) what are the pathways to the criminal justice and mental health systems for women on the SMI caseload (2) how does discretion and expansive formal social control (both benevolent and coercive) impact the lives of these women on the SMI caseload and (3) what are the gendered aspects to successful completion of SMI probation. To answer these questions a mixed-methods research design was employed. First, in-depth semi-structured interviews were completed with 65 women on the SMI caseload. Second, these interviews were supplemented with a case file review of each participant, and field observations (encompassing roughly 100 hours) were conducted at the Maricopa County Mental Health Court. Third, analysis also included 5.5 years of quantitative intake data from the SMI caseload, exploring demographic information and risk and assessment needs scores. The biographies of the women on the SMI caseload revealed similar histories of victimization, substance abuse, and relationship difficulty that previous pathways research has noted. Additionally, mental health problems directly impacted the path to the criminal justice system for some women on the SMI caseload. Results also showed many aspects of expanded social control for women on the SMI caseload. This expanded control appeared to be gendered at times and often created double binds for women. Finally, quantitative analysis showed that some predictive factors of SMI probation completion were gendered. Policy implications and summaries of findings are discussed. / Dissertation/Thesis / Ph.D. Criminology and Criminal Justice 2013

abstract: In the wake of the wars in Iraq and Afghanistan, courts and social service systems across the country have begun establishing veterans treatment courts (VTC). The first VTC was created in 2004 and there are now over 300 in at least 35 states. Yet, their underlying assumptions have not been clearly articulated and their functioning and outcomes have not been well tested. These courts aim to reduce rates of incarceration and recidivism among justice-involved veterans and draw heavily on the structure and assumptions of drug and mental health courts. However, VTCs are different in important ways. Unlike other problem solving courts, VTCs actively express gratitude to criminal defendants (for past military service) and have the ability to connect participants to a socially-esteemed identity. Earlier problem solving courts have drawn on Tyler’s theory of procedural justice to predict a path from procedurally fair treatment and social bonds with court personnel through changes in social identity to increased perceptions of legal legitimacy and, ultimately, program completion and reduced recidivism. The present study tested a modified, version of Tyler’s theory that incorporates gratitude and focuses on veteran identity as the mediating construct between fair treatment and perceptions of legal legitimacy. A cross-sectional survey design was used with a convenience sample (N = 188) of participants in two Arizona VTCs. The results indicate that perceptions of procedural justice, perceived social bonds and receipt of gratitude are positively associated with both veteran identity and perceptions of legal legitimacy. Further, veteran identity was found to be a significant mediator between the first three constructs and legal legitimacy. Finally, neither recidivism risk nor race/ethnicity moderated the relationships. The study supports the importance of acknowledging past military service and enhancing the level of veteran identity among VTC participants. Implications for practice and future research are discussed. / Dissertation/Thesis / Doctoral Dissertation Social Work 2016