Justification. Mental health policy initiatives that have reduced access to inpatient treatment have in the past led to an increased presence of persons with mental illness in the criminal justice system as well as in the forensic mental health system, in which evaluations of competency to stand trial and criminal responsibility are conducted and persons who have been found incompetent to stand trial receive treatment. Like the reform of civil commitment laws in the 1970s, managed care has reduced the use of inpatient psychiatric care for persons with psychiatric disabilities. Objectives. This study examines the effects of Medicaid managed mental health care in Massachusetts on the risk for involvement by severely mentally ill Medicaid beneficiaries in the state's inpatient forensic mental health system. Method. The study compared the risk of inpatient forensic system admission in the period before and after the introduction of managed care. Results. Severely mentally ill Medicaid beneficiaries and comparable non-beneficiaries were at equal risk for a state hospital forensic admission in the pre-managed care period. However, Medicaid beneficiaries were found to be at significantly greater risk for such admission in the post-managed care period. Significance. The implications of these findings for the relationship between the mental health, criminal justice and associated systems are discussed.
Learning Objectives: 1. Identify secondary effects of Medicaid managed care. 2. Understand relationship between mental health policy and criminal justice systems
Keywords: Medicaid Managed Care, Mental Health System
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.