Utilization of Public Sector Behavioral Health Systems and Jails Study
Joseph P. Morrissey, Ph.D., Principal Investigator
Users of both the public sector behavioral health and criminal justice systems present special problems for service system coordinators across the country. Detainees with behavioral health service needs present management and financial burdens to criminal justice systems, and are thought to suffer from poor clinical care, victimization by fellow inmates, and unjust treatment by social service systems. Poorly managed transitions of from jail to community based treatment may contribute to avoidable symptom relapse for people with behavioral health needs that could lead to further criminal justice involvement or expensive hospitalizations. Further, cost controls are being implemented in the public sector treatment system, which may or may not exacerbate these coordination and access to care problems. However, neither the prevalence of these problems, nor managed cares’ effects on users of both behavioral health and criminal justice systems, are known. This study was funded by a grant from the John D. and Catherine T. MacArthur Mental Health Policy Research Network and was carried out in collaboration with investigators at Policy Research Associates, Inc. The study’s purpose was to explore utilization and cost patterns of people with behavioral health treatment needs using jails, and behavioral health treatment funded by the state, county, and Medicaid. We explored utilization and cost patterns of people with behavioral health treatment needs using jails and behavioral health treatment funded by the state, county, and Medicaid in King County, WA. This study had two primary goals:
- To understand the service needs and experiences of people utilizing multiple systems of care-specifically the mental health, substance abuse, and criminal justice systems.
- To determine if these utilization and intake patterns have changed in response to King County’s implementation of managed outpatient mental health care in April 1995.
This study was based on an analysis of existing electronic records. We obtained data from several local agencies to link treatment records for a variety of behavioral health and jail datasets to compile complete histories of behavioral health services and jail time for a group of King County residents from July 1, 1993 to December 31, 1998. The richness of this data set will allow for findings of interest to both local and national behavioral health and criminal justice policy makers.