Results from a large, retrospective analysis of inmates with a serious mental illness (SMI) underscores the financial burden of mental illness on the criminal justice and health and human services (HHS) systems, and may provide useful information to policy makers. The results of the analysis, which evaluated patterns of arrest, utilization of services, and corresponding expenditures among nearly 3,800 inmates in a large urban county of Florida, were presented this week at the 137th American Public Health Association (APHA) Annual Meeting & Exposition.
The estimated number of adults with a SMI incarcerated each year is approaching one million. (1)Few jails have adequate funding to provide appropriate mental health care for these inmates. As a result, many may receive inadequate treatment and cause management and financial problems while incarcerated. Improved understanding of these individuals, and their diverse histories, problems and needs, may help in developing effective policies and programs.
Analyses from the retrospective data assessed these issues and sought to better understand trends among inmates with a SMI.
"The large size of the studied population allows us to identify trends, which along with other information, could be used to impact public sector expenditures associated with individuals with a SMI who have contact with the criminal justice system," said Robert Constantine, PhD, Associate Professor of Mental Health Law and Policy, University of South Florida, who moderated the session at APHA. "Specifically, this valuable knowledge can be used to create more targeted mental health programming."
At the APHA meeting, researchers presented an overview and selected findings from the Florida data set. The analysis evaluated criminal justice and HHS histories, as well as associated costs to state and local systems, of 3,769 individuals with a SMI.
Key Results and Conclusions
All analyses used data from the County criminal justice system to identify individuals in local jails during fiscal year 2003 - 2004. Participants were followed for one year prior and two years following that timeframe. A variety of state (Medicaid, mental health authority) and local (County health, social service) data sets were used to identify which of these individuals had a SMI.
One analysis looked at patterns of utilization and costs for individuals in this population. Cluster analysis was used along with utilization data to identify groups with similar patterns within and across behavioral health and criminal justice systems. Per capita and aggregate service costs for each group were also determined.