This document discusses a new integrated health care and mental health court model (IHCSM) implemented in Yuma County Mental Health Court. The IHCSM allows participants to receive brief physical and mental health assessments from an attending psychiatrist during court sessions. Results from 2013 to 2015 show the IHCSM has higher graduation rates (22% vs 11%) and lower unsuccessful completion rates (5% vs 22%) compared to the previous non-integrated model. The authors conclude the IHCSM may help address participant health issues more effectively while potentially reducing recidivism and costs. However, more research is still needed to fully evaluate the model's outcomes.

1. Integrated Health Care And Mental Health Court: A New Opportunity To Address Physical
and Mental Health Care During The Legal Process.
Liz Manjarrez, Yuma County Mental Health Court , Dr. Calvin Flowers, CFMD Inc.
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
Dec. 2013 Dec. 2014 March, 2015
Annual Participant Percent Increase
0
1
2
3
4
5
6
7
8
Dec. 2013 Dec. 2014 March, 2015
Graduate Participants
GIHCSM GNIHCSM Total Graduates
0
2
4
6
8
10
12
Dec. 2013 Dec. 2014 March, 2015
Unsuccessful Participants
UIHCSM UNIHCSM Total Unsuccessful
Conclusion:
In conclusion, the IHCSM currently measures
graduate participants at 22% vs the Non-IHCSM; it
measured at a 11% graduate. The Unsuccessful
IHCSM is at 5% vs the Unsuccessful Non-IHCSM;
it measured at 22% .
Therefore, the IHCSM may be considered a
potential and new novel approach for treating this
population with higher graduate results and lower
unsuccessful results. While at the same time, it will
potentially reduce recidivism, lower health and court
related costs, and assist in the mental health/legal
issues of this population. This model may be utilized
to meet the needs of various populations with its
mobile techniques. Additional research is required to
fully clarify outcomes measures and replicate results.
ResultsINTRODUCTION: In the USA, Mental Health
Courts have been established to address the
unique concerns of criminal justice involved
mental health patients. These courts combine
judicial supervision with monitored
psychiatric outpatient treatment. In 2013
Yuma County Mental Health Court- YCMHC
in Arizona, U.S.A. opened it’s courtroom doors
to 11 severely mentally ill participants that
had one or more felony convictions. In 2014
YCMHC had a significant increase in
participation. In 2014 a new fully integrated
physical and psychiatric health care model,
also known as, “Integrated Health Court
Service Model- IHCSM” began to be
practiced in YCMHC during the legal process
(while court was in session). Currently in 2015,
the IHCSM is still practicing and continues to
have positive results for this population.
METHODS: During the court appearance of the
individual, an attending psychiatrist for
participates is present and available for
psychiatric and physical health consultation, if
needed. Individuals may have a “brief focused
visit” with the psychiatrist to address medication
concerns, psychiatric or physical symptoms, or
other areas of clinical concern. Visits are
conducted in confidential consultation rooms,
adjoining the courtroom. There are 3 phases in
YCMHC that participants must follow in order
to graduate the program. All participants are
diagnosed SMI and must have a felony
conviction. Participants were measured by their
graduate and unsuccessful progress.
Key:
Integrated Health Court Services Model-IHCSM
Graduate Integrated Health Court Service Model-GIHCSM
Unsuccessful Integrated Health Court Service Model-UIHCSM
Non-Integrated Health Court Service Model-NIHCSM
Graduate Non-Integrated Health Court Service Model-GNIHCSM
Unsuccessful Non-Integrated Health Court Service Model-UNIHCSM
The purpose of practicing the IHCSM with a
psychiatrist in the courtroom during the legal
process is to develop a healthy integrated cohort
alliance with YCMHC Participants, YCMHC
Staff, and community agencies. The IHCSM can
also be viewed as a, “One Stop Shop” approach to
addressing mental and physical health care needs
for justice involved individuals.