Legal system involvement and costs for persons in treatment for severe mental illness and substance use disorders

Objective: Persons with co-occurring severe mental illness and substance us e disorders were followed for three years to better understand how they are involved with the legal system and to identify factors associated with dif ferent kinds of involvement. Methods: Data came from a three-year study of 203 persons enrolled in specialized treatment for dual disorders. Cost and utilization data mere collected from multiple data sources, including polic e, sheriffs and deputies, officers of the court, public defenders, prosecut ors, private attorneys, local and county jails, state prisons, and paid leg al guardians, Results: Over three years 169 participants (83 percent) had c ontact with the legal system, and 90 (44 percent) were arrested at least on ce. Participants were four times more likely to have encounters with the le gal system that did not result in arrest than they were to be arrested. Cos ts associated with nonarrest encounters were significantly less than costs associated with arrests, Mean costs per person associated with an arrest we re $2,295, and mean costs associated with a nonarrest encounter were $385. Combined three-year costs averaged $2,680 per person. Arrests and incarcera tions declined over time, Continued substance use and unstable housing were associated with a greater likelihood of arrest. Poor treatment engagement was associated with multiple arrests, Men were more likely to be arrested, and women were more likely to be the victims of crime. Conclusions: Effecti ve treatment of substance use among persons with mental illness appears to reduce arrests and incarcerations but not the frequency of nonarrest encoun ters. Stable housing may also reduce the likelihood and number of arrests.