National and state-level trends in the availability of mental health treatment services tailored to individuals ordered to treatment by a court: United States, 2016, 2018, and 2020

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 59; no. 10; pp. 1815 - 1824
• Main Authors: Pro, George, Horton, Heather, Tody, Brooklyn, Gu, Mofan, Washington, Taylor, Williams, Ashley, Gorvine, Margaret M., Johnson, O’Dell, Lovelady, Nakita, Jackson, Timikia, Ray, Azizi, Montgomery, Brooke, Zaller, Nick
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2024; Springer Nature B.V
• Subjects: Availability; Epidemiology; Health services; Medicine; Medicine & Public Health; Mental health; Mental health care; Psychiatry; Trends; United States > US; Incarceration; Court-ordered treatment; Health services; Epidemiology; Mental health
• ISSN: 0933-7954; 1433-9285; 1433-9285
• DOI: 10.1007/s00127-023-02589-8

Purpose We sought to identify trends and characteristics associated with the availability of tailored mental health services for individuals involved in the criminal justice system and ordered to treatment by a court, nationally in the US and by state. Methods We used National Mental Health Services Survey to identify outpatient mental health treatment facilities in the US (2016 n  = 4744; 2018 n  = 4626; 2020 n  = 4869). We used clustered multiple logistic regression to identify changes over time as well as facility- and state-level factors associated with the availability of specialty court-ordered services. Results Slightly more than half of the outpatient mental health treatment facilities offered specialized services for individuals ordered to treatment by a court, with wide variation between states. Nationally, there was a significant increase in the odds of offering court-ordered treatment in 2020 compared to 2016 (aOR = 1.16, 95% CI = 1.06–1.27, p  < 0.01). Notable associations included offering integrated substance use treatment (versus none, aOR = 2.95, 95% CI = 2.70–3.22, p  < 0.0001) and offering trauma therapy (versus none, aOR = 2.05, 95% CI = 1.85–2.27, p  < 0.0001). Conclusion The availability of mental health services for individuals ordered to treatment by a court is growing nationally but several states are lagging behind. Court ordered treatment is a promising strategy to improve health and reduce reliance on the carceral system as a healthcare provider. At the same time, we express caution around disparities within behavioral health courts and advocate for equity in access to incarceration alternatives.