Policy makers have grown concerned about the number of people with serious mental illness being detained in jail. Some allege that the detention rate for people with mental health service needs has increased over time as managed care cost pressures have grown. However, there are virtually no population-based studies to support this claim. Is this concern warranted or is it an urban myth? King County, Washington offers an excellent example by which to explore this issue. The county has undergone dramatic changes in social service policy in the past decade, most notably the implementation of Medicaid managed care for outpatient mental health services on April 1, 1995. We have obtained detention, Medicaid, and public sector mental health service records from July 1, 1993 to December 31, 1998 (22 months pre and 44 months post implementation). During this time period, 34% of outpatient mental health users were detained in county jails, and 6% of jail detainees had an outpatient mental health treatment history. We will determine how these rates have changed over time, and attempt to link any changes in rates to changes in mental health, Medicaid, and criminal justice policy. Pre-post comparisons across groups will enable us to assess the impact of managed care and other service trends. Implications for mental health policy and practice will be highlighted along with directions for further research.
Learning Objectives: At the conclusion of the session, participants will be able to: 1) Articulate the baseline prevalence of jail detention for people with outpatient mental health treatment histories in King County, Washington. 2) Identify key polices and/or administrative procedures that may impact these prevalence rates. 3) In light of the King County experience, asses the potential impacts of mental health policy change on the criminal justice system in their own communities.
Keywords: Managed Care, Jails and Prisons
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.