Comparing Costs of Traditional and Specialty Probation for People With Serious Mental Illness

Psychiatric Services : a Journal of the American Psychiatric Association
Jennifer L SkeemSarah M Manchak

Abstract

Specialty mental health probation reduces the likelihood of rearrest for people with mental illness, who are overrepresented in the justice system. This study tested whether specialty probation was associated with lower costs than traditional probation during the two years after placement in probation. A longitudinal, matched study compared costs of behavioral health care and criminal justice contacts among 359 probationers with mental illness at prototypic specialty or traditional agencies. Compared with traditional officers, specialty officers supervised smaller caseloads, established better relationships with supervisees, and participated more in treatment. Participants and officers were interviewed, and administrative databases were integrated to capture service use and criminal justice contacts. Unit costs were attached to these data to estimate costs incurred by each participant over two years. Cost differences were estimated by using machine-learning algorithms combined with targeted maximum-likelihood estimation (TMLE), a double-robust estimator that accounts for associations between confounders and both treatment assignment and outcomes. Specialty probation cost $11,826 (p<.001) less per participant than traditional pr...Continue Reading

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