(Jan. 24, 2017) Increasing per capita spending for public psychiatric beds could reduce jail populations in at least 35 states and the District of Columbia, according to a study by two Oregon State University researchers.
Based on an analysis of data from 44 states and DC for 2001-2009, the researchers concluded each extra dollar invested in public psychiatric hospital beds per capita could yield a 26% return by reducing the number of people behind bars.
The effect was greatest in locations where community mental health services are less available. Investing in community services also would yield a positive return on investment (ROI), the authors found, but of a smaller magnitude.
Mental Health Spending and Jail Populations
For "Intersystem return on investment in public mental health," Jangho Yoon and Jeff Luck analyzed serious mental illness (SMI) behind bars as an economic question: With regard to the number of people incarcerated in the United States, what is the ROI between public systems from investing in public mental health services?
Using a national average per capita cost of $60 per day for a jail bed, the authors found that investing $100,000 per 100,000 population for inpatient psychiatric beds in 2009 would have reduced annual jail costs by approximately $26,363 per 100,000 people, an ROI of 26%. "Every dollar spent annually on inpatient mental health by a state would yield a positive spillover benefit of a quarter dollar for the jail system by reducing the number of jail inmates," they wrote.
Results varied by state, ranging from an estimated annual reduction of $82,818 per 100,000 population in Louisiana to $2,345 in New York. Their findings were "robust," the authors said. Even after excluding the states at the extremes of the range and running other tests of their model, the pattern was consistent.
Yoon and Luck identified factors that could account for the relationship, such as
- Increasing public mental health investment may provide timely treatment for SMI that reduces the deviant behavior associated with arrest and incarceration, and
- Increasing public mental health investment may improve access to treatment for co-occurring SMI and substance abuse that is a "strong predictor" of criminal justice involvement.
Inpatient vs Outpatient Investment
Inpatient vs Outpatient Investment
Their analysis included studying how the interaction of inpatient and outpatient spending affects jail populations. Once investment in community mental health resources reached $134 per capita in 2014 dollars, the researchers found that further spending for psychiatric beds ceased to reduce jail populations. Conversely, once inpatient bed investment reached $16 per capita in 2014 dollars, further investments in community services no longer reduced jail populations.
Few states were investing enough that either community services or inpatient beds were sufficient alone to reduce mass incarceration. In 2014 dollars, only nine of the 44 analyzed states and DC spent the $134 or more per capita for community services at which point the effect of additional inpatient spending "disappeared." Only two of the 44 analyzed states and DC reached the $16 per capita threshold of inpatient spending where no further ROI in reduced jail populations was observed.
"The mental health and criminal justice systems have always closely interlocked," Yoon and Luck said. Assessing the interaction of inpatient and outpatient spending with jail populations is important, they said, because "limited state budgets may constrain total public mental health expenditures, and also force policymakers to make tradeoffs between inpatient and community mental health programs."
Doris A. Fuller
Chief of Research and Public Affairs
References:
- J. Yoon & J. Luck. (October 2016). Intersystem return on investment in public mental health: Positive externality of public mental health expenditure for the jail system in the US. Social Science & Medicine.
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