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APHA Scientific Session and Event Listing

Recorded presentation

Gary Cuddeback, PhD, MSW, Program on Mental Health Services Research, Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Martin Luther King Jr. Blvd., CB#7590, Chapel Hill, NC 27599-7590, 9199660995, gary_cuddeback@unc.edu

Purpose: Assertive Community Treatment (ACT) is cost effective for persons with severe mental illness who are the heaviest users of inpatient services; however, the potential for ACT to result in cost savings to the primary health care and criminal justice sectors has yet to be fully explored. This study compares the health care and jail utilization patterns and costs of consumers of ACT with persons with severe mental illness who did not receive ACT.

Methods: A quasi-experimental design was used to compare the health care and jail utilization and costs of 560 persons received ACT with 1,680 persons with severe mental illness who did not receive ACT, who were matched using propensity scores. Administrative data from health and behavioral health providers and the local jail in King County, Washington were accessed over a 5.5-year period (1993 – 1998).

Results: ACT recipients averaged 11 fewer jail days and had, on average, $1,200 less in total jail costs compared to those who did not receive ACT. ACT recipients had slightly fewer non-mental health inpatient stays and lower non-mental health costs but these differences were not significant.

Conclusions: ACT has the potential to reduce the use and costs of health and jail systems for those who receive it; however, the costs of providing ACT is borne by the mental health system, whereas the savings from ACT are realized by local hospitals and jails. Policies should be re-aligned such that the cost of providing ACT does not reside solely with the outpatient behavioral health system.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to discuss the primary health and jail utilization patterns and costs of persons with severe mental illness who receive Assertive Community Treatment.

Keywords: Mental Health Services, Mental Illness

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation