Nonetheless, people who received some level of ACRP intervention had a lower rate of criminal recidivism than people who received no intervention at all.
The study found that the case flow through the ACRP was a little slow. The amount of time between the Initial Opt-In Hearing and the Formal Opt-In Hearing averaged 74 days. While there are no hard and fast rules governing how long this process should take, the study found that that "the ACRP is performing rather well on the front-end of the admissions process (up to the initial opt-in stage) but that more could be done to work on the back end (time between the Initial Opt-In Hearing and the Formal Opt-In Hearing)."
The study found that the incentives and sanctions used by ACRP judges to promote compliance at status hearings, though standardized, were not tailored to correspond to participant progress.
Also, the sanctions appeared to be somewhat arbitrary, depending on the judges' personality a times. The study stated that "Although difficult to quantify, anecdotally, one appeared more reserved whereas the other seemed more charismatic; one tended to be more punitive, the other a little more assertive."
The goal of any mental health court is move along a continuum from basic implementation (requiring judicial leadership) to integration (forging partnerships) with the criminal justice, behavioral health and service delivery systems, and finally to institutionalization (interwoven into the fabric of a community).
The study found that, long this continuum, the ACRP is not quite there yet but it has come a long way since its inception. It has made significant strides in forging partnerships and building relationships with a vast array of key stakeholders in the Anchorage community who have an important impact on the program as well as the people it serves.
Qualitative data, such as interviews with participants, is highly valuable in obtaining data for Quality of Life outcomes. Quality of Life is highly subjective and hard to measure. The most common, and perhaps reasonable, method is to ask the subject about its Quality of Life.
Although in most cases, the only way to determine Quality of Life outcomes is to ask the subject itself, the nature of the subject matter with mental health patients presents certain difficulties. There is always some risk of unreliability with data gained from self-reporting. Here, those risks are exacerbated. First, mental health patients are more likely than the average person to misperceive his or her own mental states, emotions, or condition. Second, these mental health patients are or were at risk of re-institutionalization if their progress does not meet treatment program standards. Thus, they might have misrepresented their progress and general Quality of Life as more positive than it actually was.
Although interviews with stakeholders do not reveal much about the two major outcomes, Quality of Life and Criminal Recidivism, but were valuable for determining overall program health. The participants have expertise in the field and incentive to providing helpful information. Thus, the participant's responses were effective for determining overall institutional health and for obtaining suggestions and recommendations for improvement.
The data gained from interviews with stakeholders about their opinions about the effectiveness of the program could be vulnerable to self-interest. Because the existence and operation of the ACRP has a huge effect on their own work, the participants might skew their responses in order to promote change that would help the participants or their agency. For example, a participant from an agency receiving the outflow from ACRP might claim that the ACRP needs to prepare better documentation in order to reduce workload from the participant's own agency.
Qualitative data, such as that gained from observations, are valuable because they identify important, unforeseen factors which may not have been considered of the planning of the experiment. For example, the effects of judge personality on sanctions, and by extension, to criminal recidivism might not have been considered during the planning of the study but emerged as a significant factor after observation of judicial status hearings. It is important to note that these observations of judicial status hearings, originally, were only meant to determine ACRP compliance with Bureau of Justice Assistance's best practices.
However, qualitative data is usually less structured and possibly subjective, especially when they are based on observations. An example of this is in the observation of ACRP judges at status hearings. Through observation, the study found that the personality and posture of the judge had a significant effect on sanctions. Sanctions have a significant effect on the subject's compliance. Compliance, in turn, has a significant effect on criminal recidivism, a major program outcome.
One way to improve qualitative data is to convert it into quantitative data. However, it is sometimes difficult to convert qualitative data into congruent units without leaving out important information.
Although there are potential data reliability issues arising from the sensitive nature of the subject matter and the professional, inter-agency environment, these issues do not bear on the basic inquiries of the study. The study is successful in providing definitive, well-supported answers to all three of the major research questions. It demonstrated that the ACRP reduces criminal recidivism, increases quality of life for participants, and reduces overall program costs for the state.
Outcomes from the Last Frontier: An Evaluation of the Anchorage Mental Health Court (Alaska Mental Health Trust Authority, Ferguson-Hornby-Zeller, 2008).
Improving Responses to People with Mental Illnesses: The Essential Elements of a Mental Health Court (Thompson, Osher, Tomasini-Joshi, 2008).
Mental Health Courts: Decriminalizing the Mentally Ill. (Irwin Law, Schneider-Hyman-Bloom, 2007).
Mental Health Courts. (Wiley Encyclopedia of Forensic Science, Schneider, 2009).
Law & Psychiatry: Mental Health Courts: Their Promise and Unanswered Questions (Journal of Psychiatry Services, 52:457-458, April 2001)
Justice For Trust Beneficiaries Initiative. (Alaska Mental Health Trust Authority, 2008).
Mental Health Courts: Decriminalizing the Mentally Ill. (Irwin Law, Schneider-Hyman-Bloom, 2007), p. 3
Justice For Trust Beneficiaries Initiative. (Alaska Mental Health Trust Authority, 2008), p. 1
Law & Psychiatry: Mental Health Courts: Their Promise and Unanswered Questions (Journal of Psychiatric Services, 52:457-458, April 2001), p. 457.
Outcomes from the Last Frontier: An Evaluation of the Anchorage Mental Health Court (Alaska Mental Health Trust Authority, Ferguson-Hornby-Zeller, 2008), p. 1.