Cost Shifting to Jails after a Change to Managed Mental Health Care (Washington State)
The implications from our analyses are important for policy.
First, our results show that there is a trend away from deinstitutionalization of persons with mental illness. However, instead of reinstitutionalization in mental hospitals, or even general hospitals, the institutionalization is in jails.
Second, it is likely that the treatment of mental illness is less effective in jail, even when psychiatric care is provided, than in a hospital specializing in care for the mentally ill.
Third, the overall cost of care is likely to be greater, when counting both the short-term and long-term costs.
Fourth, this trend, like the de-institutionalization that started in the 1960s, is driven in large part by economic incentives instead of best treatment considerations.