How mental health courts function: Outcomes and observations.

The present study examines legal, service use and substance abuse outcomes for a sample of participants in the Washoe County, Nevada MHC and suggests what occurs during MHC enrollment that is associated with these outcomes. A comparison of participants and graduates to a comparable control group reveals significantly fewer jail days for the MHC participants and graduates, both when measured against the control group and their own pre-mental health court histories. There was also a significant drop in psychiatric hospitalization days for the MHC participants and graduates and a decrease in positive drug and alcohol tests over the course of enrollment in the court. Observations of the MHC sessions reveal a nonadversarial atmosphere in which participants interact directly with the judge and in which praise and encouragement are issued far more often than sanctions. These interactions with the judge, which are frequent and common among all MHC participants who are engaged in the process, are associated with the observed outcomes and serve to contextualize them. It is imperative that research continues on a variety of aspects of the MHC process to determine whether these courts are truly effective and if so, for whom and why.