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Mental health courts have proliferated across the U.S. in recent decades, promising to end vicious and expensive cycles of incarceration by diverting people with mental illness into community-based supervision and treatment. They’re a type of “problem-solving” court, along with other specialized dockets like drug, veterans and family treatment courts.

The courts aim to reduce recidivism, increase compliance with treatment and improve quality of life. But the process can be long and arduous for participants who are often navigating poverty, housing instability and social isolation. Programs typically last one to two years and require regular court appearances, counseling and random drug tests. Success can depend on whether a county has enough treatment, housing, transit and community support to make diversion real.

Nationally, research has shown mental health courts reduce recidivism, but it’s unclear if they improve psychiatric symptoms. Critics say the courts have outpaced research on their effectiveness, coerce people into treatment, result in longer justice system involvement, intervene too late and distract from other reforms. Others say programs may encourage police to arrest someone in order to connect them with treatment.

“Mental health courts aren’t a solution. They’re a symptom of our systemic problems in the mental health system,” said Tony Ohlhausen, director of research and policy with the Illinois chapter of the National Alliance on Mental Illness. “They do great work, and people do benefit from them. But I would categorize mental health courts as a band-aid.”

Proponents say the programs save money. Every year, Illinois prisons incarcerate about 30,000 people at a total estimated cost of $1.5 billion. Nearly half of those people have a history of mental illness. By diverting people from prison through mental health courts and other interventions, one Illinois program estimates it has saved the state nearly half a billion by avoiding incarceration costs over the past 15 years, with $85 million expected to be saved this fiscal year.

In Illinois, it can be hard to get information on what’s happening inside courts. The judiciary is exempt from public-records requests and doesn’t publish annual reports on problem-solving courts. Michigan, by contrast, publishes detailed data on program cost and efficacy.

Despite limited research and transparency, Illinois counties have continued to launch new mental health courts, and advocates call for more, raising big questions about fiscal accountability and oversight. Meanwhile, the Trump administration has voiced support for mental health courts, even while cutting Medicaid — the nation’s single largest funder of mental health services.

In recent months, the Illinois Answers Project and MindSite News reached out to every court in Illinois for data, collected public records from grant-funded courts and interviewed officials and participants to give a complete picture of the state’s mental health courts. What emerges is a promising model with limited funds supporting small oases in an otherwise barren desert.

Woodworth successfully completed her program and says it transformed her life. But that’s rare. Most applicants are rejected because of prior offenses, refusal to undergo an evaluation or other disqualifying factors. Of those who are accepted, just half graduate. Some are unable to participate or voluntarily withdraw. A small number have died. Others, like Sean Buchanan, were cut from programs for refusing medication or committing new crimes.

“I was abusing my medicine, really, and that led to my downfall,” he said.

Nearly two million Illinoisans don’t have access to mental health courts to begin with.

“Sure, there are some bumps in the road,” said Bill Blundell, problem-solving court manager for the Administrative Office of the Illinois Courts (AOIC). “But from my point of view, they’re successful because people are getting the help that they need at a much more intense rate than they may if they were just on regular probation or they were incarcerated.”

Thousands participate in mental health court

Woodworth said her mental health unraveled in high school after her father, a local police sergeant, was arrested and later convicted of raping four women. She fell into a cycle of drugs, homelessness and repeated brushes with the law. Then her brother died from an overdose, and she didn’t know how to cope.

“In my brain, I was either going to be dead or in prison for the rest of my life at 30 because I was going so hard,” Woodworth said. She applied for mental health court, and after several months in jail, was accepted.

Woodworth is one of more than 6,000 people who have participated in a mental health court in Illinois over the past two decades, according to data provided by courts. The true total is likely higher, as courts lost some early data when they transitioned to newer computer systems. Even so, it’s a tiny percentage of the more than 200,000 criminal cases filed annually.

Mental health courts began operating in Illinois in the early 2000s. In 2008, lawmakers passed the Illinois Mental Health Court Treatment Act, which allows the chief judge of each judicial circuit to establish a mental health court. Then, in 2015, the Illinois Supreme Court approved standards and a process for certifying problem-solving courts.

That same year, Loyola University Chicago researchers assessed recidivism in three counties and concluded that the answer to whether mental health courts work is “a somewhat tentative ‘yes.’” Illinois took another look at the issue in 2020, when a literature review found the courts “generally show positive results” but “lack definitive evidence of their effectiveness.” As a result, the authors concluded, further expansion was “unjustified.” But courts continued to open.

AOIC has certified 31 mental health courts in Illinois, and most have been recertified, which Blundell said shows courts are working. None have been denied recertification, but if a court isn’t performing well, some additional training may be required, he said. Illinois is in the process of updating its standards, which are expected to emphasize treatment over punishment.

The state began building a new public dashboard to share data on problem-solving courts in 2022, and it’s still in the works. In response to questions, AOIC provided limited figures on mental health courts: Since 2017, 860 people have graduated, and 763 have failed to do so. That’s a slightly lower graduation rate than one recent nationwide study of mental health courts, which found 57% of people discharged from a program graduated. Graduation rates vary widely across the state.

Woodworth said she’s seen people relapse while in a program, or even after graduating. “Everybody has their own pathway to recovery,” she said. “But the seed is planted with the specialty courts.”

Some courts track data on demographics, outcomes and recidivism or contract independent evaluations. Several of the most recent county-level analyses available (in Cook, McHenry and Winnebago) show evidence of reduced recidivism. Other courts don’t keep data, citing limited staffing, funding and outdated computer systems. For some, the state’s recertification process is their only form of assessment. That makes it challenging to determine statewide not just whether mental health courts help, but which parts of the model matter most.

Court staff say graduation and reduced recidivism aren’t the only measures of success; they also point to reduced hospitalizations and improved quality of life, housing, relationships, employment and education. Those metrics can be harder to measure since courts often lose touch with participants after graduation, so the state has been developing an exit survey and collecting impact stories of graduates like Woodworth.

After being accepted into the program, Woodworth walked out of the lockup with a pair of jail-issued shoes and a paper booking slip. She moved to transitional housing. At the time, her husband was applying for drug court, and the court vetoed his application three times. Woodworth advocated for him, and he was eventually accepted and moved into a sober living house.

As they progressed through the programs together, the Woodworths moved into a home with roommates and found work at a Jimmy John’s sandwich shop. But when they discovered drugs in the home, they left, choosing to live in a tent for a couple weeks rather than be tempted. The court helped them pay for a hotel and connected them with housing assistance.

Woodworth graduated in 2024 after more than a year in the program. She now serves on her county’s reentry council and advocates for criminal justice reform. She’s still in the process of sealing her charges so they’re not publicly accessible. Her husband graduated in August 2025 after two years. He chairs Narcotics Anonymous meetings, works with young violent offenders and runs an emotional wellness art group.

“I never in a million years thought that recovery was possible,” Woodworth said.

Sanctions and rewards

In mental health court, judges use a system of sanctions and rewards to incentivize compliance. Rewards include praise, gift cards and necessities like diapers, toothpaste or socks. Sanctions include admonishments, writing assignments and jail time. Successful completion can lead to charges being dismissed and expunged. Failure can mean prison.

The courts typically focus on people who are high-risk and high-need, and most require a guilty plea. Court staff work in teams of a judge, prosecutor, defense attorney, probation officer, treatment provider, peer support specialist and case manager. Their camaraderie is often apparent at final graduation ceremonies, complete with pizza and cake.

At the state’s newest mental health court, in Kankakee, participants may receive fidget spinners, support from a service dog and the chance to spin a wheel for a prize. Last summer, a young woman who had been complying with regular drug testing received a hug from the judge and a box of Reese’s Pieces candy. A man who’d repeatedly missed appointments was sanctioned to 24 hours in jail and led out of the hushed courtroom in handcuffs.

Another participant, Sean Buchanan, pleaded to stay in the program. He had abused his medication, hallucinated and robbed an elderly acquaintance. He and his mother both asked the judge for another chance. But the judge cited a “concerning pattern” of behavior and cut him from the program. It was the court’s first termination.

“I was doing really good until I got put on that medicine,” Buchanan, 34, said on a call from prison, where he said he’s not receiving treatment for schizophrenia and bipolar disorder. “I was seeing things that weren’t real.”

People who don’t graduate tend to have refused treatment or committed new offenses such as resisting arrest, drug possession, damaging property or domestic violence, said Kelvin McCabe, a public defender in Rock Island County.

Access to housing, transportation, and inpatient treatment are major barriers. Most participants rely heavily on state and federal benefits such as Medicaid. A 21-day inpatient program could be $30,000, McCabe said, “so if they don’t have insurance, they’re certainly never going to be able to afford it because the people that we have are indigent or homeless.”

This is a central reality of mental health courts: Many of the factors that determine success sit outside the courtroom. Participants may falter not only because of their symptoms or decisions, but also because they cannot get into treatment, cannot keep insurance, or lose services when providers fall away. Staff, too, struggle with burn-out and turnover.

A 2022 independent review of Will County’s problem-solving courts surveyed participants on barriers to participation. They cited work conflicts, lack of transportation, physical and mental health symptoms, lack of child care and drug or alcohol use issues. Most participants relied on a public defender, and 39% reported being homeless at some point during the program.

“Be a little more flexible,” one respondent urged the court. Others recommended staff increase availability on weekends, allow Zoom appearances, provide child care, reduce jail sanctions and help participants regain driver’s licenses.

Another study, on Peoria’s courts, recommended providing bus passes and gas vouchers. “I didn’t have ample transportation,” one participant told researchers. “Anytime I left the house, it was like going on a vacation, you know, planning everything out.”

‘A relief let off your shoulders’

Daniel Brown, 43, has been in and out of jail in Illinois and Indiana since his early 20s. In 2015, he stole a bottle of alcohol and a box of mac and cheese. The theft landed him in Cook County Jail, where he stayed for months before pleading guilty to retail theft and being sentenced to mental health court.

Brown had dealt with mental illness his whole life, but it wasn’t until mental health court that he received a diagnosis: schizophrenia and bipolar disorder. “It made sense when they explained it, because it broke down a lot of things I was dealing with,” he said.

Brown said mental health court provided structure and support. Initially, it was difficult to forgo drinking and smoking marijuana. Eventually, Brown said, he “got tired” and “played the game.” He stayed at a specialized rehab facility in Evanston. Then, court staff helped him find an apartment in Cicero. Along the way, he participated in a documentary about mental health court.

Brown graduated in 2017 after two years and had his charge dismissed. “It’s like a relief let off your shoulders,” he said.

Cook County is one of at least two counties that expunge charges automatically. In others, graduates have to apply for expungement themselves. At least two courts don’t dismiss charges at all. Program durations also vary: sometimes longer than a typical criminal process, sometimes shorter.

Today, Brown regularly sees a psychiatrist and case worker and takes medication, which reduces his auditory hallucinations. Last year, he traveled to Jamaica for his father’s funeral. In his living room, he keeps a framed newsclipping of his judge’s retirement from mental health court, alongside a memorial card from the funeral and a Jamaican bank note.

“It gave me something to live for,” Brown said, “something better to do with my time.”

Millions don’t have access

On the second floor of the Kankakee County courthouse, a man appeared on the screen in an orange jumpsuit, asking to be admitted to mental health court. But while he had committed a crime in the county, he didn’t reside there and could not be admitted. As the judge prepared to end the call, the man made a final plea.

“What do I have to do to get my mental health right?” he asked the judge.

She wished him “good luck” and moved on to the next case.

“You hate to turn away somebody who really needs help,” Judge Lindsay Parkhurst said later in an interview. “… But you can’t give quality help if you’re diluting the services.”

Nearly two million people in Illinois — nearly 15% of the state’s population — live in counties with no mental health courts. Most courts only accept residents, but there is wiggle room. Kankakee has allowed people to relocate for the program, and Peoria has accepted residents from neighboring Tazewell. But it gets trickier when someone lives further away.

Retired Judge Mark Shaner previously oversaw 12 counties in southeastern Illinois, none of which have a mental health court. He said people in his circuit “certainly” need one, but that requires staff, funding and treatment providers. “Like so many things, it’s resources,” he said.

Champaign County is the most populous county in the state without a mental health court. It’s also an area of high need. A 2019 survey showed one in five residents reported having a mental illness — the highest percentage of any region in Illinois. The county previously operated a mental health court, but it shut down in 2013 due to disagreements between the state’s attorney and the judge overseeing the court. Other mental health courts have also closed.

Elisabeth Pollock, a public defender in Champaign, has been trying to restart the county’s mental health court for years, calling it an “absolute necessity.” But it’s challenging to secure treatment providers, court staff and funding simultaneously. “It’s not a matter of willingness,” she said. “It’s a matter of how to get it done.”

In its 2026 policy platform, NAMI Illinois called on the state to expand mental health courts to all jurisdictions and ensure each court has “sufficient capacity.” The group also urged Illinois to enact legislation expanding mental health court reciprocity across jurisdictions.

Ideally, every county would have a diversionary program, Blundell said. He helped launch three new drug courts last year, including one that serves three rural counties, which are “joining together to combine their resources.”

Even some small counties have been able to make it work. In the Fourth Judicial Circuit, three counties — Effingham, Montgomery and Christian — each have fewer than 35,000 people and operate their own mental health courts. “We’re trying to give services to the people we can with the resources that we have,” said Wes Poggenpohl, an associate public defender in Montgomery County. “It’s worth it.”

Redeployed in Illinois

Navy veteran Shawn Gibson entered Grundy County’s mental health court in 2024. He said trauma from his time in the military — including nine months deployed to the Persian Gulf starting in 2003 — led him down “a path of self-destruction.”

He was living in Morris, Illinois, to help oversee a new power plant when he was charged with his sixth DUI, on Sept. 11, 2022. “I was having a bad moment,” Gibson said. He faced four years in prison. That’s when his attorney started talking to him about mental health court.

“It just finally clicked in my head that I haven’t had time to help myself the way that I needed to. And I knew for a long time that I was really struggling,” he said.

Gibson built his life around the program. He relocated back to Grundy County, supported himself on Veterans Affairs disability benefits and worked as a cook. He completed the program ahead of schedule and is now back working at a power plant in Tennessee.

“The program really helped me to gain the tools that I needed to be able to live a life without being a victim of my own mind,” Gibson said.

Mental health courts in Illinois rely on a combination of federal, state and local grants. Most, like Grundy County’s, receive funding from Adult Redeploy Illinois, an initiative established by the Illinois Crime Reduction Act in 2009 to incentivize diversion. The act required jurisdictions to commit to reducing prison admissions by 25% in order to receive funding. In 2015, a state commission set a goal of reducing the prison population by a quarter within a decade. As of last year, it had dropped by 40% since 2009 due to a combination of factors, including a drop in crime and changing attitudes around sentencing.

Adult Redeploy is now a $13 million initiative. Last year, about 60 diversion programs served nearly 3,000 people statewide. Approximately 80% of the programs are problem-solving courts.

The initiative is required to submit annual reports to the governor and legislature but failed to produce them on time in recent years, citing staffing limitations. Illinois Answers and MindSite News began inquiring about the program last year, and, a few months later, Adult Redeploy produced and publicly released reports on the four most recent years.

Last fiscal year, Adult Redeploy estimates its programs saved the state $83 million. The average cost of an intervention was a little over $4,000 per participant, compared to an average incarceration cost of nearly $53,000 per person annually. Those estimates, however, have not been independently audited.

Like Gibson, more than half of Adult Redeploy participants successfully completed their programs last fiscal year. And since 2009, nearly two-thirds of all participants have stayed out of prison. All told, more than 11,000 people have been diverted, saving $485 million in incarceration costs.

Mental health courts are just one small part of Adult Redeploy and may also be more expensive than the average program intervention. But because the grants fund a variety of local services, estimating per-client mental health costs “would be difficult without a full study,” said Cristin Evans, a spokesperson for the program.

“Even if it breaks even, this is the more humane thing to do,” said Michelle O’Brien, a consultant with the National Center for State Courts who has trained court staff across Illinois.

Funding for mental health courts typically goes toward treatment providers and contracted services, O’Brien said. It’s important to have multiple sources of funding, she said, “because we never know when one of those funding sources might end.”

Last summer, Grundy County’s health board abruptly shut down its mental health programming, forcing the court to contract new providers. Participants faced a temporary gap in services. “For me, it took me a month and a half to get reestablished with a therapist,” Gibson said.

Funding cuts under the current administration also present challenges. In July, Trump issued a widely criticized executive order on “ending crime and disorder on America’s streets” that pointed to mental health courts as “an effective method of addressing homelessness” and directed the attorney general to “prioritize available funding” to support their expansion.

But the administration has slashed social services that program participants rely upon, including Medicaid. As many as 400,000 Illinois residents are estimated to be at risk of losing their coverage due to sweeping changes to the public insurance program in the One Big Beautiful Bill Act.

Taking a trillion dollars out of Medicaid over the next decade is “not increasing access to mental health treatment,” Ohlhausen said.

Earlier this year, the administration announced plans to cut nearly $2 billion in funding to mental health and addiction programs nationwide. The U.S. Department of Health and Human Services reversed course hours later, but the incident set off alarm bells through Illinois’ courts system.

Blundell said he hopes Illinois mental health courts will continue receiving federal funding. One current Bureau of Justice Assistance grant is “business as usual” so far, he said.

“What that looks like in the future,” he said, “I don’t know.”

Have you or a loved one gone through a mental health court program? Reach out to us at ghauck@illinoisanswers.org and josh.mcghee@mindsitenews.org. This story was made possible by a grant from The Richard H. Driehaus Foundation to the Illinois Answers Project.

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April 27, 2026 at 06:00AM