The mental health system is an ever present topic these days in the media and I think we can all agree that improvements can be made. One of the advocates for change that I’ve talked about before is Pete Earley (click here for that post) who points out the shortages in facilities to receive treatment. He says that, as a result of the shortage of space in jails and treatment facilities, individuals are often shuffled back and forth between facilities and never truly receive proper treatment.
The truth is that there are many people who don’t receive the treatment they need. It’s been reported that over a quarter of homeless individuals report psychological distress compared to 3.6% of the general population (Gelberg & Linn, 1989). Many of these individuals do not receive treatment. I remember when I first came to USC, I was told of a program in Los Angeles where case managers were assigned to 50 homeless individuals and were given access to preventative care throughout a year. The preventative care is especially crucial because homeless individuals often use emergency facilities as their primary care, using up valuable resources for issues that could be taken care of with preventative care. It was found that the county saved over a million dollars; however, because of budget cuts, this program was cut.
Well, a similar study was done among those with schizophrenia and bipolar disorder.
The researchers kept track of these participants from 2005 until 2012. For these seven years, the researchers identified which people received medication or therapy for their illness, and which people received no treatment. The researchers also identified which of these people were arrested during these years.
The results form this study indicated…
…that the patients who received medication for their mental illness were much less likely to be arrested than those who did not receive treatment. Therapy was also shown to help people with mental illness stay out of the criminal justice system. The first 90 days after hospitalization seemed to be especially important, and patients who were given medication during this time were the least likely to face arrest.
Another great feature of this study was that participants were enrolled in Florida Medicaid, meaning that any individuals who received medication or therapy used government assistance in order to afford their treatment. But even with this, was it more useful for the government to incarcerate individuals or send them to treatment?
The results from Dr. Van Dorn’s study show that it cost the government more money to send patients through the criminal justice system than in did to provide them with mental health treatment. The average cost of medical treatment for study subjects was $68,000 per person during the full seven years of the study. In contrast, the justice system costs for the subjects who were arrested averaged $95,000 per person. This is a difference of about $10.00 per day per person.
I don’t think many people realize how imperative it is for those who need treatment to receive it. To be honest, I don’t think I get the depth of it, but I’m learning. Incarceration is not always the best answer and resources need to be shifted. Unfortunately, there is a bigger paradigm shift that is needed than what is in sight. The question is, will the shift happen? How can we make it happen sooner? I don’t know the answer, but I’d love to hear ideas from you. What are your thoughts?
Gelberg, L., & Linn, L. S. (1988). Social and physical health of homeless adults previously treated for mental health problems. Hospital and Community Psychiatry, 39, 510-516.
- Imminent Danger: The Problem with Mental Illness and the Justice System
- Why mental illness is not a one-lane highway
- A follow-up conversation on mental health and the criminal justice system
- Reducing mental health stigma- How different are we all?
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