title: Prospective study of violence risk reduction by a mental health court.
abstract: OBJECTIVE
  Although many mental health courts (MHCs) have been established to reduce criminal justice involvement of persons with mental disorders, research has not kept pace with the widespread implementation of these courts. Whereas early MHCs were restricted to persons charged with nonviolent misdemeanors, many MHCs now accept persons with more serious charges for whom ameliorating risk of violence is a greater concern. This study evaluated the relationship between MHC participation and risk of violence by using a prospective design. It was hypothesized that MHC participation would decrease the risk of violence during a one year follow-up compared with a matched comparison group.
  
  
  METHODS
  The sample included 169 jail detainees with a mental disorder who either entered an MHC (N=88) or received treatment as usual (N=81). Seventy-two percent had been charged with felonies. Participants were interviewed at baseline and during a one-year follow up, and their arrest records were reviewed. Propensity-adjusted logistic regression evaluated the relationship between MHC participation and risk of violence, controlling for potential confounders such as history of violence, demographic characteristics, baseline treatment motivation, and time at risk in the community.
  
  
  RESULTS
  MHC participation was associated with reduction in risk of violence (odds ratio=.39). During follow-up, 25% of the MHC group perpetrated violence, compared with 42% of the treatment-as-usual group.
  
  
  CONCLUSIONS
  MHC participation can reduce the risk of violence among justice-involved persons with mental disorders. The findings support the conclusion that the MHC model can be extended beyond persons charged with nonviolent misdemeanors in a way that enhances public safety.
authors: Dr. McNiel, Dr. Delucchi, and Dr. Binder are with the Department of Psychiatry, University of California, San Francisco, as was Dr. Sadeh when this research was conducted (email: dalem@lppi.ucsf.edu). Dr. Sadeh is now with the National Center for Posttraumatic Stress Disorder, Department of Veterans Affairs Boston Healthcare System, and with the Department of Psychiatry, Boston University School of Medicine.
authors: Dale E
authors: DE
authors: McNiel
authors: Dr. McNiel, Dr. Delucchi, and Dr. Binder are with the Department of Psychiatry, University of California, San Francisco, as was Dr. Sadeh when this research was conducted (email: dalem@lppi.ucsf.edu). Dr. Sadeh is now with the National Center for Posttraumatic Stress Disorder, Department of Veterans Affairs Boston Healthcare System, and with the Department of Psychiatry, Boston University School of Medicine.
authors: Naomi
authors: N
authors: Sadeh
authors: Dr. McNiel, Dr. Delucchi, and Dr. Binder are with the Department of Psychiatry, University of California, San Francisco, as was Dr. Sadeh when this research was conducted (email: dalem@lppi.ucsf.edu). Dr. Sadeh is now with the National Center for Posttraumatic Stress Disorder, Department of Veterans Affairs Boston Healthcare System, and with the Department of Psychiatry, Boston University School of Medicine.
authors: Kevin L
authors: KL
authors: Delucchi
authors: Dr. McNiel, Dr. Delucchi, and Dr. Binder are with the Department of Psychiatry, University of California, San Francisco, as was Dr. Sadeh when this research was conducted (email: dalem@lppi.ucsf.edu). Dr. Sadeh is now with the National Center for Posttraumatic Stress Disorder, Department of Veterans Affairs Boston Healthcare System, and with the Department of Psychiatry, Boston University School of Medicine.
authors: Renée L
authors: RL
authors: Binder
mesh_terms: D000328:Adult; D003415:Crime / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007603:Jurisprudence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D065840:Protective Factors; D040242:Risk Reduction Behavior; D014754:Violence / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D055815:Young Adult