Decision-Making in Mental Health Courts: A Mixed-Methods Analysis of Legal and Extra-Legal Factors in Evaluations of Mentally Ill Defendants

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Authors

Prager, Nathan Walker

Issue Date

2025

Type

Dissertation

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en_US

Keywords

attribution , disparity , focal concerns theory , mental health courts , mixed-methods

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Abstract

Mental health courts (MHCs) are specialized programs that aim to divert individuals with serious mental illness away from incarceration and into treatment. Their goal is to reduce recidivism and promote rehabilitation by addressing the underlying mental health needs that can contribute to criminal behavior. As the number of MHCs continues to increase, more research is needed to understand the processes and operations of these courts. Issues of disparity and equal access to these programs is one area in need of such research. This research describes a mixed-methods analysis grounded in classical social psychological theories of attribution and heuristics in addition to the focal concerns framework from the criminal justice literature. This dissertation describes three studies investigating decision-making among MHC workgroups. The first study describes ethnographic observations of three remote MHCs in the United States. Using a flexible coding strategy, this qualitative analysis focused on violation and termination hearings as important instances of decision-making within these programs. The second study describes another qualitative analysis of in-depth interviews with MHC workgroup members. These interviews focused on the referral and admission process as an important instance of decision making in addition to the work group members’ perceptions of disparity within their programs. Finally, the third study describes an experimental survey using vignettes to investigate the effects of defendant race, gender, and offense type on MHC diversion decisions.

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