From case management to court clinic: examining forensic system involvement of persons with severe mental illness

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Adolescent; Adult; Case Management; Community Mental Health Services; Female; Forensic Psychiatry; Humans; Male; Massachusetts; Mental Competency; Mental Disorders; Middle Aged; Outcome Assessment (Health Care); Severity of Illness Index




The study examined the flow of a state mental health agency's case-managed clients into its forensic mental health court clinic systems for evaluation of competency to stand trial (CST) for a criminal offense. An analysis of merged encounter data from the case management and court clinic systems revealed that roughly 2% of the case-managed population were referred to court clinics for evaluation of CST during a 1-year period, but that these 2% represented roughly one eighth of that year's court clinic evaluees. The likelihood of this involvement was higher for males, African-Americans, and Latinos, and for persons with a history of substance abuse, and also was associated with higher levels of previous hospitalization. In addition, CST evaluees were more likely to be non-White, male, and uninsured than were case-managed evaluees. These data indicate that demographic characteristics, substance abuse, and lack of insurance are potential risk factors for forensic and, by inference, criminal justice system involvement among persons with mental illness.


Ment Health Serv Res. 2000 Mar;2(1):41-9.

Journal/Book/Conference Title

Mental health services research

Related Resources

Link to Article in PubMed

PubMed ID