Nearly one in three Texas prison and state jail inmates have a history with the state mental health system. These individuals commonly experience repeated contact with the justice system.

Specialized Mental Health Public Defender (MHPD) programs are a cutting-edge therapeutic defense approach that targets the needs of this special population. MH Public Defenders are familiar with mental health-related law, and they provide social work services during and after the trial to improve the chance of a favorable case outcome. In another increasingly prevalent model of therapeutic justice, Mental Health Courts (MHC) provide court-based case management and close supervision to divert defendants away from jail and into long-term community mental health treatment.


PPRI’s innovative evaluation of these two initiatives combined 800,000 criminal case records from three of the five largest cities in Texas with mental health records from the State Department of State Health Services. Among other things, the study found:

  • By linking defendants to mental health treatment, individuals involved in both the MH Public Defender and MH Courts were significantly more likely to stay engaged in mental health services for at least six months after the criminal case was disposed.

  • Both MH Public Defenders and MH Courts significantly reduced the chance of a guilty verdict.

  • Among those mentally ill defendants who were found guilty, however, those represented by a public defender were less likely to spend time in jail and more likely to have a sentence of probation.

  • Both MH Public Defenders and MH Courts successfully reduced the chance a person with mental illness would re-offend.

These findings are a strong endorsement for the continued support of criminal justice programs designed to treat rather than punish defendants whose offense is a result of a mental illness.




  • Archival Data Analysis

  • Stakeholder Interviews


  • Dottie Carmichael, Ph.D. (Principal Investigator)

  • Trey Marchbanks, Ph.D. (Co-Principal Investigator)

  • Mary Kirven

  • Laura Klaverma

  • Mary Beth Durkin

  • Tony Fabelo