Mental Health Treatment and Criminal Justice Outcomes
NBER Working Paper No. 15858
Are many prisoners in jail or prison because of their mental illness? And if so, is mental health treatment a cost-effective way to reduce crime and lower criminal justice costs? This paper reviews and evaluates the evidence assessing the potential of expansion of mental health services for reducing crime. Mental illness and symptoms of mental illness are highly prevalent among adult and child criminal justice populations. The association between serious mental illness and violence and arrest is particularly strong among individuals who are psychotic and do not adhere to medication. Two empirical studies augment the empirical research base relating mental illness to crime. In a recent community sample of adults, we find higher rates of arrest for those with serious mental illness and with substance abuse. Among youth, even with family fixed effects, antisocial personality scores predict future school problems and arrests. A large body of research tracks mental health and criminal justice outcomes associated with treatments and social policies. Reviews of the cost-effectiveness of treatments for children with behavioral problems, mental health courts, and mandatory outpatient treatment are inconclusive.