The final two articles in the Systems Enhancement Evaluation Initiative (SEEI) special issue look at the implementation and outcomes of a Court Outreach Program (COP) for people who are legally involved, and have severe and persistent mental illness.
The first article outlines the implementation evaluation of a Court Outreach Program offered by the Ottawa Branch of the Canadian Mental Health Association (CMHA Ottawa Branch). The COP provides outreach, community-based treatment and support to people with mental illness in the legal system. As a result of the Ministry’s new investments, the COP received more funding, enabling it to increase service capacity.
The study used qualitative and quantitative approaches to determine:
- If the program is being delivered to the intended population;
- If it is being implemented as planned;
- Strengths and weaknesses.
The results show that the program mainly serves individuals who are: single, male, experiencing serious mental illness with diminished functional ability and who also have a range of psychosocial needs; services are provided from a client-centered perspective. The intake/assessment workers also provide a range of supports to court personnel. However, there is a potential for under-referral of clients to the program, and there are also challenges to the assessment/intake process.
Program strengths include competent and knowledgeable court outreach staff. Staff contribute to the legal and mental health system, and provide access for clients to a range of community supports and treatments, including navigation through the court system. Challenges include limited program capacity; access to support and services outside of CMHA; and bottlenecks in the intake/assessment process.
The article recommends:
- Improving access to information, and providing more resources and services
- Increasing staff, decreasing workload
- Providing specific training and education
- Creating and disseminating more knowledge about the court outreach program
The second study evaluated the outcomes of the program. Evaluation questions included:
- Are there changes in functioning for clients over the course of participation in the Court Outreach Program?
- Are there changes in the number of hospitalizations or number of days in hospital for clients in the program?
- What are the legal outcomes of clients during their participation in the program?
- What types of services delivered by the program are predictive of reduced rates of recidivism?
The study sample included 45 clients in an active group who had been in the program for at least three months and were still receiving services; and 50 clients who were followed subsequent to their discharge from the program.
Client outcomes in the study showed increased community ability and reduced homelessness for the group of 45 active clients; and, increased community ability and diminished severity of mental health symptoms for the 50 clients who had been discharged from the program.
Only four percent of discharged clients were found to be incarcerated at termination and two percent were detained at termination through the Ontario Review Board. No significant changes were found in the proportion of those using alcohol or other drugs, number of hospitalizations or number of days in hospital. However, the clients who had been discharged from the program did show a trend toward an increased number of days in hospital while receiving services in the program relative to the two-year period prior to entering the program. Further, findings indicated that clients with physical health problems that received long periods of services seemed less likely to reoffend.
See “An Evaluation of the Implementation of a Court Outreach Program for People With Severe and Persistent Mental Illness Who Are Legally Involved” Canadian Journal of Community Mental Health (2010; 29 [Supplement 5]: 139-156), available at www.metapress.com, and “An Evaluation of the Outcomes of a Court Outreach Program for People with Severe and Persistent Mental Illness Who Are Legally Involved” Canadian Journal of Community Mental Health (2010; 29 [Supplement 5]: 157-172), available at www.metapress.com. Full contents of the SEEI Special Supplement Issue of the Canadian Journal of Community Mental Health are available at www.metapress.com.
For more information about SEEI, contact Heather Bullock firstname.lastname@example.org.