OBJECTIVE: The authors examined the outcomes of mental health
consultation provided to a municipal court and the court's resulting
interventions for mentally ill persons who committed minor crimes. One aim
of the consultation program was to avoid criminalization of mentally ill
people who committed minor offenses. METHODS: Clinical and forensic records
of 96 persons charged with misdemeanors and referred to a clinical
psychologist court consultant for evaluation were studied. Determination of
good versus poor outcome during a one-year follow-up period was based on
clients' status during the year after the court's disposition. Poor outcome
was defined as the occurrence of one or more of four events during the
follow-up year: psychiatric hospitalization, arrest, significant physical
violence against persons, and homelessness. RESULTS: Fifty-six defendants
(58 percent) were mandated to receive judicially monitored mental health
treatment, as recommended by the psychologist court consultant, and 33 of
them (59 percent) had a good one-year outcome. The relationship was
statistically significant. CONCLUSIONS: Nonclinicians in the criminal
justice system should have psychiatric assistance in making appropriate
dispositions for mentally ill persons. If the judge is considering mental
health treatment as a condition for eliminating or reducing punishment,
then, to the extent justified by the law and the nature of the offense, the
judge should both mandate and monitor the treatment on an ongoing
basis.
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