Examining the Impact of Non-Specialty Court Mental Health Diversion Programs on Recidivism: A Systematic Review and Meta-Analysis

Mental health court diversion programs are one approach aimed at reducing the rates of mental illness amongst people in jails and prisons around the world. Although meta-analytic work has examined the effects of specialized mental health courts on recidivism, less is known about non-specialty court mental health diversion programs. In the current study, we conducted a systematic review and meta-analysis to examine evidence regarding the effectiveness of non-specialty court mental health diversion programs on reducing the risk of recidivism for adults with mental illness. Following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, Embase, Web of Science, PSYCINFO, and Criminal Justice Abstracts. We found eight articles eligible for final inclusion, reporting 12 separate effect size estimates and including a total of 4,214 participants. We extracted relevant data and conducted a meta-analysis using a random effects model to establish a pooled odds ratio (OR) with 95% confidence interval to estimate the association between non-specialty court mental health diversion programs and recidivism. Participation in these types of court diversion programs was associated with significantly reduced odds of recidivism (OR = 0.47, 95% CI = 0.35–0.65). However, this finding should be interpreted with caution due to concerns about study quality and substantial heterogeneity, as reflected in the prediction interval (0.158–1.418). Further high-quality research is needed to confirm findings and enable a more robust and detailed understanding of the relationship across a range of contexts and subgroups. There is also a need to test service improvements aimed at increasing the rate of diversion amongst those eligible, improving the impact on recidivism and on key mental health outcomes.