Han Woojae, Redlich Allison D
When this work was done, Mr. Han was with the School of Social Welfare, State University of New York, Albany. He is currently with the Department of Social Work, Binghamton University, Binghamton, New York. Dr. Redlich is with the Department of Criminology, Law, and Society, George Mason University, Fairfax, Virginia. Send correspondence to Dr. Redlich (e-mail:
Psychiatr Serv. 2016 Apr 1;67(4):384-90. doi: 10.1176/appi.ps.201500006. Epub 2015 Nov 16.
A core component of mental health courts (MHCs) is the provision of community treatment in order to reduce arrests. However, research on the components of treatment received by MHC participants is rare. This study examined the impact of community treatment on arrests in an MHC sample (N=357) and a sample from the traditional criminal justice system (N=384).
Data were from the MacArthur MHC Project, which includes objective and subjective information from four MHCs with comparison samples at each site. Interview data were collected for six months before and six months after entry into the MHC or legal system. National data from arrest records over one year were also obtained. Treatment-related variables were compliance (appointments and medication), perceptions (motivation and perceived voluntariness), and use of nine types of community treatment. A fixed-effects regression controlled for selection bias between groups.
The regression model indicated significant increases in treatment motivation and use of community mental health and substance abuse services among MHC participants, compared with treatment-as-usual participants; however, the perceived voluntariness of treatment decreased in the MHC group. For the treatment-as-usual group, none of the treatment variables were associated with future arrest. For the MHC group, increased medication compliance and use of mental health services were associated with a significant decrease in arrests.
Consistent with the MHC goals, findings indicated increases in receipt of community treatment among MHC participants. For the MHC sample, but not the treatment-as-usual sample, increased treatment was associated with reduced recidivism.
心理健康法庭（MHCs）的一个核心组成部分是提供社区治疗，以减少逮捕。然而，关于MHC参与者接受的治疗组成部分的研究很少。本研究考察了社区治疗对一个MHC样本（N = 357）和一个传统刑事司法系统样本（N = 384）中逮捕情况的影响。
数据来自麦克阿瑟心理健康法庭项目，该项目包括来自四个心理健康法庭的客观和主观信息，每个地点都有对照样本。在进入心理健康法庭或法律系统之前的六个月和之后的六个月收集访谈数据。还获得了来自一年逮捕记录的全国数据。与治疗相关的变量包括依从性（预约和用药）、认知（动机和感知到的自愿性）以及九种社区治疗的使用情况。采用固定效应回归控制组间选择偏差。
回归模型表明，与常规治疗参与者相比，MHC参与者的治疗动机以及社区心理健康和药物滥用服务的使用显著增加；然而，MHC组中治疗的感知自愿性有所下降。对于常规治疗组，没有任何治疗变量与未来逮捕相关。对于MHC组，用药依从性的提高和心理健康服务的使用与逮捕的显著减少相关。
与心理健康法庭的目标一致，研究结果表明MHC参与者接受社区治疗的情况有所增加。对于MHC样本，而非常规治疗样本，治疗的增加与再犯率降低相关。
