Mental health courts are an increasingly common option for defendants whose mental health impedes the effectiveness of traditional justice processing. Determinations of eligibility for mental health court are informed by various sources, including consideration of the availability of community-based services. When the range, scope, or heterogeneity of community-based services is limited, some otherwise eligible defendants are unable to connect with appropriate services. For defendants with difficult-to-treat conditions (e.g., active suicidality, personality disorders), this challenge of connecting with services is especially difficult. This article discusses the challenges of connecting mental health court participants with appropriate services and proposes recommendations to mitigate these challenges. Recommendations include the establishment of specialized treatment programs, ensuring treatment programs are informed by the risk-need-responsivity model of criminal recidivism, trauma and cultural considerations, use of integrated case management services, and implementation of flexible treatment mandates.

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