Racial Variation in Mental Health Court Experiences and the Associations of These Experiences With Recidivism

• Author: Woojae Han,Jason Matejkowski,Sungkyu Lee
• Published date: 01 July 2020
• Date: 01 July 2020
• DOI: http://doi.org/10.1177/0093854820921886
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2020, Vol. 47, No. 7, July 2020, 808 –828.

DOI: https://doi.org/10.1177/0093854820921886

Article reuse guidelines: sagepub.com/journals-permissions

© 2020 International Association for Correctional and Forensic Psychology

808

RACIAL VARIATION IN MENTAL HEALTH

COURT EXPERIENCES AND THE ASSOCIATIONS

OF THESE EXPERIENCES WITH RECIDIVISM

WOOJAE HAN

Soongsil University

JASON MATEJKOWSKI

The University of Kansas

SUNGKYU LEE

Soongsil University

Little is known about how mental health court (MHC) experiences (including satisfaction and sanctioning, incentivizing, and

life change events) differ by race and how this variation affects recidivism among MHC participants. This study examined

how MHC experiences and recidivism differ between White (n = 170) and Black (n = 132) participants from four different

MHCs in the United Sates. Negative binomial regression models, conducted separately for the two groups, indicated that life

changes were associated with decreased arrests and that court sanctions were associated with increased number of arrests for

both White and Black participants. Higher program satisfaction was positively associated with recidivism among Black

participants only. To provide equitable services for people convicted of a crime with mental illness, professionals should

acknowledge racial variation in the experiences of MHC participants (both within the MHC and the communities in which

they are situated) and how these experiences relate to recidivism.

Keywords: mental health court; recidivism; criminal justice; racial variation

INTRODUCTION

The overrepresentation of people of color in the U.S. criminal justice system is well-

known (Alexander, 2012; Tonry, 2010). In addition to these disparities, overrepresentation

of people with mental illness in the criminal justice system is a long-standing problem

(Prins, 2014; Torrey et al., 2014). Research has demonstrated that mental health courts

(MHCs) can function to reduce recidivism and connect people with mental illness to treat-

ment (Honegger, 2015; Lowder et al., 2018; Sarteschi et al., 2011). However, there is a

dearth of research on how and for whom desired outcomes are brought about. In particular,

it is not yet clear whether racial disparities exist in MHCs similar to what is seen in other

AUTHORS’ NOTE: Correspondence concerning this article should be addressed to Sungkyu Lee, Associate

Professor, Graduate School of Social Welfare, Soongsil University, 369 Sangdo-Ro, Dongjak-Gu, Seoul 06978,

South Korea; e-mail: slee90@ssu.ac.kr

921886CJBXXX10.1177/0093854820921886Criminal Justice and BehaviorHan et al. / Racial Variation in MHC Experiences

research-article2020

Han et al. / RACIAL VARIATION IN MHC EXPERIENCES 809

parts of the justice system. In addition, little research has directly examined how variation

of MHC experiences by race affects future criminal behaviors of MHC participants. The

primary goal of this study is to examine how MHC experiences and outcomes differ by

race. The MHC experiences include program satisfaction, life changes after MHC enroll-

ment, and receipt of sanctions and incentives; recidivism is the outcome of interest.

MHCS

MHCs are specialized programs for defendants with mental illness that seek the adjudica-

tion of criminal charges and municipal code violations by using a problem-solving model.

MHCs divert people charged with a crime into the community to receive necessary treatment

and support services instead of incarceration (National Institute of Justice, n.d.). Although

these courts may differ somewhat in structure, objectives, and function by jurisdiction (Wolff

& Pogorzelski, 2005), the essential elements of MHCs include a screening process to deter-

mine who can participate in the program, multidisciplinary planning and administration from

dedicated personnel (e.g., judge, prosecutor, defense counsel, treatment providers), clear

terms of participation and informed choice to participate, and confidentiality safeguards. In

addition, MHCs aim to increase participants’ access to evidence-based treatments and ser-

vices, monitor participants’ adherence to court conditions, and employ sanctions and incen-

tives to promote adherence to these conditions (Thompson et al., 2007).

CONCEPTUAL FRAMEWORK

Figure 1 depicts the framework guiding our analyses. In summary, MHCs frequently

employ sanctions and incentives as a method of encouraging behaviors and engagement in

services that are aimed at initiating and sustaining positive life changes among their partici-

pants (Linhorst et al., 2010; Redlich et al., 2006). How and to what extent participants

experience these sanctioning, incentivizing, and life events will shape their perceptions of

satisfaction with the MHC (Canada & Watson, 2013; Redlich & Han, 2014). The extent to

which positive life changes are imparted will influence whether MHC participants return to

criminal behavior and incarceration (Han, 2019; Ward & Maruna, 2007). Importantly, these

processes are not immune to the personal and systemic biases that permeate American soci-

ety and that contribute to discrimination and to differential experiences based upon race/

ethnicity status (Bonilla-Silva, 1997). For example, implicit biases against people of color

may lead to dissimilar application of sanctions and incentives to MHC participants. This

unequal treatment can lead MHC participants who are people of color to develop lower

perceptions of satisfaction with the court and to receive fewer benefits from MHC participa-

tion (i.e., positive life changes) than White participants. Moreover, variation in recidivistic

outcomes that are played out largely in the community may also reflect the larger racial/

ethnic disparities seen in policing, law enforcement, and America’s court system (Brewer &

Heitzeg, 2008).

Racial and Ethnic Discrimination

Considerable disadvantage and hardship can be imposed upon others by persons who,

simply by their position in the bureaucratic structure, are allowed to exert wide discretion

in whether to unleash the force of the justice system on those identified as transgressing