Involvement in the US criminal justice system and cost implications for persons treated for schizophrenia

BMC Psychiatry

Research Article

Haya Ascher-Svanum¹  Allen W Nyhuis¹  Douglas E Faries¹  Bruce J Kinon¹  Daniel E Ball¹ 

[1] Eli Lilly and Company, Indianapolis, IN, USA;

关键词: Schizophrenia;    Criminal Justice System;    Mental Health System;    Medication Possession Ratio;    Total Health Care Cost;   

DOI  :  10.1186/1471-244X-10-11

 received in 2009-06-16, accepted in 2010-01-28,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIndividuals with schizophrenia may have a higher risk of encounters with the criminal justice system than the general population, but there are limited data on such encounters and their attendant costs. This study assessed the prevalence of encounters with the criminal justice system, encounter types, and the estimated cost attributable to these encounters in the one-year treatment of persons with schizophrenia.MethodsThis post-hoc analysis used data from a prospective one-year cost-effectiveness study of persons treated with antipsychotics for schizophrenia and related disorders in the United States. Criminal justice system involvement was assessed using the Schizophrenia Patients Outcome Research Team (PORT) client survey and the victimization subscale of the Lehman Quality of Life Interview (QOLI). Direct cost of criminal justice system involvement was estimated using previously reported costs per type of encounter. Patients with and without involvement were compared on baseline characteristics and direct annual health care and criminal justice system-related costs.ResultsOverall, 278 (46%) of 609 participants reported at least 1 criminal justice system encounter. They were more likely to be substance users and less adherent to antipsychotics compared to participants without involvement. The 2 most prevalent types of encounters were being a victim of a crime (67%) and being on parole or probation (26%). The mean annual per-patient cost of involvement was $1,429, translating to 6% of total annual direct health care costs for those with involvement (11% when excluding crime victims).ConclusionsCriminal justice system involvement appears to be prevalent and costly for persons treated for schizophrenia in the United States. Findings highlight the need to better understand the interface between the mental health and the criminal justice systems and the related costs, in personal, societal, and economic terms.

【 授权许可】

CC BY   
© Ascher-Svanum et al; licensee BioMed Central Ltd. 2010