Economics of decriminalizing mental illness: when doing the right thing costs less

Delgado, Darci; Breth, Ashley; Hill, Shelley J.; Warburton, Katherine; Stahl, Stephen M.

doi:10.1017/s1092852919001792

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Post‐arrest diversion is another point in the pathway where mental health interventions could be cost‐effective, but again clear evidence is awaited. A US estimate suggested that mental health diversion can lead to over $1 billion in savings per year (Delgado et al., 2020).…”

Section: Economic Evidence Of Mental Health Interventions Along the C...mentioning

confidence: 99%

“…Based on this, mental health interventions can be categorised by their timing in relation to criminal behaviour: Point of contact: Some criminal behaviours, such as violence, can be the direct result of psychopathology. Mental health interventions can be delivered at this point. Post‐arrest: Growing attention is being paid to the ethical problem of ‘criminalisation of mental illness’ and the high costs associated with incarceration of people with mental illness (Delgado et al., 2020). This implies a need to make comparisons between diverting for mental health interventions versus continuing a regular CJS pathway. Incarceration/punishment: Interventions at this point refer to those designed for offenders/prison inmates with mental health needs, including specific interventions in forensic psychiatry. Post‐incarceration: Interventions can be provided at/after release from prison for people with mental health problems, including follow‐up services to avert future crime and improve health.…”

Section: Introductionmentioning

confidence: 99%

“…cost-benefit, cost-effectiveness, health technology assessment, implementation challenges, mental health economics, societal costs 2. Post-arrest: Growing attention is being paid to the ethical problem of 'criminalisation of mental illness' and the high costs associated with incarceration of people with mental illness (Delgado et al, 2020). This implies a need to make comparisons between diverting for mental health interventions versus continuing a regular CJS pathway.…”

Section: Introductionmentioning

confidence: 99%

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Economic evaluations of mental health interventions in criminal justice

Knapp

Wong

2023

Criminal Behav Ment Health

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Background: Mental health interventions targeting crime perpetrators are available. An overview of the current scenario of their economic benefits will help policy decisions. Aim: To provide an update on economic evidence for mental health interventions in criminal justice, and to identify challenges and responses in using economic evidence to inform policy. Method: Narrative review with an analysis frame that organises evidence around four points on the criminal justice system pathway: (a) point of contact; (b) post-arrest; (c) incarceration/punishment and (d) post-incarceration. Results: There is a paucity of high-quality economic evidence, especially from cost-benefit analyses. However, there is some evidence of cost-effectiveness in support of interventions at the point of incarceration, such as cognitive behavioural therapy, multisystemic therapy for juvenile delinquents, therapeutic communities, electronic monitoring and telepsychiatry in forensic psychiatry settings. There is also evidence that post-incarceration interventions such as assertive community treatment can be cost-effective. Conclusion: There remain large evidence gaps. There are also challenges in turning economic evidence on mental health interventions in criminal justice into policy changes and improved practice, such as hidden costs, silo budgeting

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Section: Economic Evidence Of Mental Health Interventions Along the C...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Economic evaluations of mental health interventions in criminal justice

Knapp

Wong

2023

Criminal Behav Ment Health

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“…Often, a fraction of the cost for incarceration would provide financing for mental health service provision which would have a better chance of bringing about recovery. Prior research suggests that improving access to mental health services might be effective in reducing criminal involvement (Delgado, 2020; Jácome, 2021). However in many countries, community mental health services operate independently from the criminal justice system (Kidia et al , 2017; Tamburello et al , 2017).…”

Section: Introductionmentioning

confidence: 99%

Mental health and criminal justice: bridging two worlds

Madondo

Putten

2022

JFP

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Purpose The purpose of this study was to describe programs that aim at programs to divert people with a mental condition from the criminal justice system to mental health services are being initiated, but reporting is limited and fragmented. This study described programs that aim at diverting persons with mental health conditions out of criminal justice systems to community mental health services, with the intention to inform research and practice. Design/methodology/approach A scoping review was used to map and synthesise diversion programs. Ten online data bases were searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used to direct the selection of sources. Research and evaluation publications and grey literature published from 2010 to 2021 in English language were included. Findings Eight distinct diversion programs were identified across 24 countries or territories covering five phases of the criminal justice process. Diversion programs included crisis intervention teams, the electronic linkage system, mobile crisis units, the criminal justice liaison program, problem-solving courts, the abstinence-based program, the community equivalence program and the forensic assertive community treatment program. Although distinct programs have the potential to form a system of diversion across the continuum of the criminal justice process, only two territories moved in that direction. Diversion programs reported overwhelmingly originated from high-income countries. Practical implications Stigma that labels people with mental health conditions as violent and dangerous need to be addressed. It is important to place diversion systems on national policy agendas and advocate for evidence-based interventions. Originality/value The study provides a blueprint on diversion systems to set a research agenda and develop a road map, tailored towards local contexts.

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“…But it is cheaper than the alternatives. 13 As leaders in the field of mental health, how do we make provision of that care a priority? In other words, how do we prevent the policy pendulum from continuing to swing between extremes of neglect within institutions and neglect outside of institutions?…”

mentioning

confidence: 99%