Seattle University Collaborative Projects - International Academy of ...

In November 2010, the Hogg Foundation for Mental Health awarded a two-year grant to TexasAppleseed and Disability Rights Texas to develop a report to outline issues and suggest revisionsto the Texas Mental Health Code to better reflect the state’s current behavioral health system.The grant was an outgrowth of a recommendation by a state continuity of care task force that thestate’s code was in need of a full-scale revision. In fact, the Texas Mental Health Code has notbeen substantially revised since 1985 – more than a quarter century ago. In contrast, behavioralhealth care standards, practices, and services have seen dramatic changes during this period. Thegrantees retained Dr. Susan Stone (an attorney/board certified psychiatrist) as a consultant. Sheformed a Steering Committee, composed of judges, attorneys, law professors (including thispresenter), and clinicians. In addition, she facilitated forty-plus public meetings across the statewith over 5,000 participants. Because of complexities, out-of-date provisions and terminology,the retention of legal standards inconsistent with modern treatments, a significant increase of lawenforcement and criminal justice overlap with behavioral health issues, and an array of otherconcerns, the Steering Committee recommended a wholesale repeal of the 1985 code, andrecommended enactment of a new structure. The report will be submitted in final form to theTexas Legislature in advance of the next legislative session which commences in January 2013.By the time of the conference, it is hoped that a new mental health code will have been enacted.Predictors of Criminal Justice Outcomes Among Mental Health CourtParticipants: The Role of Perceived Coercion and Subjective Mental HealthRecoveryChristina Pratt, Nathan Kline Institute for Psychiatric Research, USA (cpratt@nki.rfmg.org)Research on mental health courts (MHCs) to date has been disproportionately focused on thestudy of recidivism and re-incarceration. Despite the strong conceptual links between the MHCapproach and recovery-orientation, the capacity for MHCs to facilitate recovery has not beenexplored. This user-informed (MH/CJ) community based participatory (CBPR) study assessesthe extent to which MHC practices align with recovery-oriented principles. We report on theexperiences and perceptions of 51 MHC participants across four metropolitan Mental HealthCourts, specifically: 1) how defendants’ perceptions of court practices, particularly with regardto procedural justice and coercion, relate to perceptions of mental health recovery and psychiatricsymptoms, and, 2) how perceptions of procedural justice and mental health recovery relate tosubsequent criminal justice outcomes. The authors hypothesized that perceived coercion andmental health recovery would be inversely related, that perceived coercion would be associatedwith worse criminal justice outcomes, and perceptions of mental health recovery would beassociated with better criminal justice outcomes. Results suggest that perceived coercion in theMHC experience was negatively associated with perceptions of recovery among MHCparticipants. Perceptions of “negative pressures,” a component of coercion, were importantpredictors of criminal justice involvement in the 12 month period following MHC admission,even when controlling for other factors that were related to criminal justice outcomes, and that anincrease in procedural justice was associated with a decrease in symptoms but curiously not to anincrease in attitudes toward the recovery. Implications and future directions are discussed. Co-499