Re. Clark et al., Legal system involvement and costs for persons in treatment for severe mental illness and substance use disorders, PSYCH SERV, 50(5), 1999, pp. 641-647
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.