Recorded presentation

Gary S. Cuddeback, PhD, Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 101 Conner Drive, Suite 302, Chapel Hill, NC 27514, 919-966-0995, cuddeback@mail.schsr.unc.edu and Joseph P. Morrissey, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, 101 Conner Dr. Ste.302, Willowcrest Bldg., CB#3386, Chapel Hill, NC 27599-3386.

Over one million bookings into US jails involving persons with severe mental illness occur annually. The policy of discontinuing social security benefits (both monthly income and health insurance) for persons incarcerated in U.S. jails has received increasing scrutiny. Intended to prevent fraudulent receipt of benefits during incarceration, this policy may be disadvantageous to detained persons with SMI, as health insurance (Medicaid) increases their likelihood of receiving post-release mental health services. To this end, the effect of having Medicaid and receiving mental health services following an index release on future re-incarcerations has yet to be fully explored.This presentation addresses that issue with data on 4,482 arrests involving 2,215 persons with SMI who were released from a large urban county jail in the U.S. over an 18-month period (1996-98). A case-control design is employed to identify patterns of mental health service use and re-incarcerations in the 90-days following an index release; cases (n= 2,752) are arrests for persons with SMI who were enrolled in Medicaid upon release from jail and controls (n= 1,730) are arrests for persons with SMI who were not enrolled on Medicaid upon release from jail. Multi-variable statistical analyses are used to determine the extent to which Medicaid benefits lead to service receipt and the extent to which receipt of services serves as a deterrent to subsequent re-incarceration in a 90-day post-release interval, controlling for demographics (age, race/ethnicity, gender) and seriousness of charges. Implications for policy, practice, and further research will be highlighted.

Learning Objectives:

• Participants will develop a better understanding of the relationships between health insurance, seriousness of offense, and use of community mental health services and re-incarcerations for persons with severe mental illness.

Presenting author's disclosure statement:
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.

Recorded presentation