Date of Award


Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)



First Advisor


Second Advisor

Julie Costopoulos

Third Advisor

Catherine Nicholson

Fourth Advisor

Mary Beth Kenkel


Mental health courts (MHC) were designed to divert the overwhelming number of individuals with mental illness involved in the criminal justice system from incarceration through specialty court proceedings intended to meet their unique needs. Individuals who have both mental health problems and substance use are at a disadvantage. For them, this combination contributes to more severe mental health symptoms, physical health issues, interpersonal challenges, and legal problems. The co-occurrence of mental illness and substance use is increasing in prevalence within both the community and justice system settings; however, few studies have explored the effectiveness of MHCs for this specific population (Peters, Kremling, Bekman, & Caudy, 2012). The current study examined the efficacy of a single mental health court in Brevard County, FL at reducing recidivism among a sample of MHC graduates. Recidivism was defined as the occurrence of new arrest, length of time to reoffend, and the severity of new arrest. Mental health diagnosis, substance use, demographic variables, and days in MHC were examined in relation to recidivism outcomes in this sample. This study expanded the current literature by including follow-up data at one-year and three-year post-MHC program completion, thereby allowing the examination of longer-term recidivism outcomes. Additionally, in a secondary analysis, the association between type of substance used and recidivism was examined. Results from the current study found that 29% of MHC graduates were re-arrested at one year and 46% were re-arrested at three years. The mean length of time until re-arrest was 148 days at one-year and 324 days at three-years. Approximately 48% and 59% of graduates committed felony re-offenses at one and three-years, respectively. There were no significant differences between graduates who were re-arrested and those who were not re-arrested at one-year or three-year post-MCH exit in terms of age, gender, days in MHC, mental health diagnosis, and substance use. Additionally, no significant effect was found of these same variables on crime severity and time to re-arrest at the one-year and three-year follow-up was found. However, trends in the data suggest that substance use may be an important risk factor for recidivism as roughly 60% of the graduates re-arrested at one and three years after completion of MHC used at least one substance. Alcohol and marijuana were used by the majority of re-offending graduates in this sample. At three-years post-MHC exit, 31% of re-offenders who used substances were polysubstance users. Understanding the relationship between characteristics of MHC graduates and long-term post-program outcomes is critical for identifying those individuals most at risk for difficulties when they re-enter their communities.


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