Mental Health Court Shown to be Economical
> 7/18/2007 8:32:01 AM

According to the report, Mental Health Care for Ohio State Prisoners: The View from the Directorís Office (2000), prisons and jails house more people with mental illnesses than do the countryís mental health institutions. To alleviate this misplaced burden, Mental Health Courts (MHC) have been set up in several states across the US. These courts offer an alternative for handling offenders with mental disorders, but their effectiveness has not been thoroughly studied. The RAND corporation recently produced one of the first reports to conclusively show that a specific MHC is economical.

RAND was contracted to do a fiscal impact study of the Allegheny County MHC for a two year period. It was easy for them to establish that the MHC reduced recidivism rates, but it took more finesse to determine that they are cost-effective. This was done by making two comparisons: to a counter-factual group that would have existed if offenders had been handled along normal sentencing guidelines, and to previous arrests of the same offenders now in MHC. RAND found that for the first year, the increased costs in mental health treatment were approximately offset by the savings from prison costs. In the second year, costs began to level off, and the annual saving of $9,584 was statistically significant. It is unfortunate that the study ended here. These results are promising, but they certainly needed to be expanded with a more long-term study. It seems likely that the cost-effectiveness of MHC become more apparent as early treatment ripples out to prevent problems in the future.

There are some limitations of the study, but RAND instills great confidence by readily admitting these possible problems. For example, it reveals that it was unable to exactly match all of the arrest records because of the difficulty of correlating chaotic government records. It also admits that counter-factual numbers were only estimates and didnít always differentiate between average cost and marginal cost.

Some findings about the different savings among subgroups could be very useful to states wishing to set up more focused MHC. The greatest savings were for those with the most serious crimes and disorders. Even if some doubt remains about RANDís results, at the least, the government should attempt to offer the MHC route to those charged with felonies, afflicted with psychoses, or suffering from a disorder severe enough to significantly impair function. If savings were found after only two years, imagine how much potential there is once the system has time to refine itself and to heal chronic offenders, who lacking treatment, return to prison at higher rates than those criminals without a diagnosable mental health disorder.

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