How will we know if mental health courts are effective? The answers provided by future evaluation research will reflect the extent to which the social and procedural complexity of mental health courts drives the research design and plan. This article identifies the research challenges associated with studying the effectiveness of an intervention that is nonstandardized by nature and highly dependent on macro and local influences within the environment as well as personal preferences and relationship dynamics within the intervention itself. Explored are the research challenges related to isolating the independent effects associated with mental health courts. The article concludes with recommendations for how best to evaluate mental health courts to inform best practice and policy.

Persons who have mental illness are over-represented among jail and prison inmates. Efforts have been advancing to stem the flow of offenders who have mental illness into the criminal justice system. The mental health court is the newest of these approaches. There is scant empirical evidence on the performance of mental health courts. Available evidence suggests that recruitment is feasible and engagement in treatment is possible. This paper examines the mental health court model in the context of its likely therapeutic and antitherapeutic consequences and considers whether there are other ways to engage the court as a therapeutic agent that yield a better portfolio of consequence. An alternative approach to the mental health court is outlined.

The mental health court is the newest venue for rerouting persons with mental illness from the criminal justice system to the treatment system. Mental health courts share with drug courts the mission of offering therapeutic alternatives to jail. But their success, however, depends on the nature of the illnesses to which they attempt to treat, the strength of the connection between those illnesses and criminal behavior, and the effectiveness of treatment as a deterrent. To explore these connections, mental health courts are found to have substantial limitations in terms of their potential impact on criminal behavior and incarceration of people with mental illness. Serious concerns about fairness are also raised. An alternative strategy for judicial intervention on behalf of offenders with mental illness is suggested.