Study: Mental health courts showing positive results

A New York-based policy research group says Hennepin County's criminal mental health court is showing positive results.

Mental health courts are specialized courts that deal with people's underlying mental health problems as well as their crimes. The aim is to reduce repeat offenses and increase compliance with outpatient treatment and medication.

Minnesota's chief justice and the research group unveiled the findings Friday at the history center before an audience of judges, social workers, county commissioners and advocates.

Criminal mental health courts are relatively new; Hennepin County's began only six years ago. Today, there are about 250 of them around the U.S. They began in response to what the justice system began seeing was a revolving door for the mentally ill.

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People suffering from illnesses such as schizophrenia and bipolar disorder would commit property crimes or assaults. Police would arrest them; a judge would sentence them; they would do their time and be released, only to start the cycle over again. Through treatment, medication and intense supervision, mental health courts try to end that cycle.

Because mental health courts are relatively new, there've been few studies on how well they work. Minnesota Chief Justice Eric Magnuson said evaluating the courts is as important as having them.

"We do what we think is right, but we need to find out if our assumptions are correct," Magnuson said. "Do we get the results that we hope to get? Here, the results are quite promising."

"Here, the results are quite promising."

Through a MacArthur Foundation grant, New York-based Policy Research Associates studied four mental health courts in Hennepin County, San Francisco, San Jose, and Indianapolis. The research showed generally about a 20 to 25 percent improvement in the outcomes for offenders who went through mental health courts compared to those who did not.

For example, the research showed those who went through Hennepin County's mental health court were, on average, likely to get arrested again in four months. Those who did not go through the specialized court got arrested again in less than three weeks.

Sociologist Henry Steadman, who heads the New York-based policy research group, said it's important to view those numbers in context.

"Taking a hard-core, challenging population that has failed repeatedly in all three systems: criminal justice, substance abuse and mental health," Steadman said, "and has cycled and is a particularly challenging group, and have come up with an intervention that is a 20 to 25 percent improvement on almost all the measures. My evaluation is that's pretty damn good in today's world."

But at a time when county budgets are strapped for funding, mental health courts don't show an immediate savings. The study's findings show they actually cost a little more during a person's first year in the program because that person is getting more services. Steadman said any savings don't show up for about a year and a half, and that can be a tough sell to the community.

Richard Hopper, Hennepin County's mental health judge, said he tells funders up front the program won't save money immediately, but that it will use money more wisely. Hopper said many of the mentally-ill people who get in trouble with the law, especially the homeless, end up at hospital emergency rooms.

"Well what does it cost for an emergency room doc to prescribe a medication? Probably about $750," Hopper said. "Well if they're in mental health court and you've made an appointment for them to see a doctor at the mental health center, it probably costs about $150."

Ramsey County also has a mental health court. County Commissioner Jim McDonough said the presentation reinforced his support of such courts, but he questioned whether overall they will ever save money. He said their value is in a safer community and a better quality of life:

"Great cost savings on an individual basis, but on a system-wide basis I'm not so sure that there's going to be a true cost savings to the taxpayer other than we'll be able to be providing more humane and appropriate treatment for people with mental health within the criminal justice system," McDonough said.

The study is in a second phase that will compare the actual costs and benefits of mental health courts with typical criminal courts.