Thursday, August 12, 2010

Would diverting mentally ill from jails and prisons expand the economy?

Jackie Shannon, who is chairwoman of the Board of Trustees of MHMR Services in San Angelo, has a column today in the Standard-Times which opens with the question, "Would you be surprised to learn that the odds of a seriously mentally ill person being in jail or prison in Texas compared with being in a hospital are 7.8 to one?" She supplies some interesting analysis mostly culled from a recent study from the National Sheriff's Association - More Mentally Ill Persons Are In Jails and Prisons Than Hospitals: A Survey of States (pdf) -  but also included a provocative, perhaps counterintuitive argument on the negative economic impacts of failing to supply adequate mental health care:
Obviously it doesn’t make fiscal sense to cut mental health services and hospital beds if the result is higher costs to the prison system. So, what’s a Legislature to do?

Ray Perryman, of the well-regarded Perryman Group, in a January letter to state Rep. Jim Pitts, chairman of the Texas House Appropriations Committee, wrote:

“For several years, I have been studying the economic and fiscal issues surrounding treatment for mental health and substance abuse. Even beyond the human cost of such problems (which is enormous and defies measurement), the drain on the economy and the State’s social services system is also substantial.

“With inadequate treatment, overall costs can notably escalate; for those Texans without private insurance, obtaining treatment can be impossible due to financial constraints.

“In a 2009 study by my firm, (‘Costs, Consequences, and Cures!!! An Assessment of the Impact of Severe Mental Health and Substance Abuse Disorders on Business Activity in Texas and the Anticipated Economic and Fiscal Return on Investment in Expanded Mental Health Services’), my analysis revealed that mental health and substance abuse cost the state economy billions of dollars each year, and that increasing funding for these services brings a net payoff to the state. The components of this total cost include medical spending related to treatment, comorbidity and disability expense, lost income and productivity, incarceration, homelessness and mortality.

“Simply stated, if all of the costs and associated losses associated with these factors could be eliminated, the Texas economy would be approximately 10 percent larger than its present size. While such an outcome is not practical, finding cost-effective methods to reduce the incidence and severity of mental health and substance abuse problems is an important endeavor that can improve the state’s fiscal situation. Clearly, improving mechanisms to provide care to those in need is an important task.”
If Perryman's right, maybe the best wedge argument against slashing mental health services isn't merely sympathy for the plight of those in need. Maybe it's that doing so would harm economic growth while alleviating the problem would promote it.

1 comment:

John said...

It will do much more than expand the economy. Mental Health is one of the most egnored maladies of American society resulting in billions of dollars in damages and expenses not otherwise accounted for in the statistics. The mentally challenged are suckers for every scam game in the books including perpetrations conspired by governmental agencies that would not otherwise be considered a scam because of our "Buyer Beware" mentality/standards. In one case I've personally observed, the victim neglected to take her meds because she used to have her parents that monitored her behavior and medications. As a result she went off the deep end and ended up in an altercation with an uncaring police department and an uncaring court and judicial system that refuses to take in to account the mental health disability. While incarcerated her identity was stolen, her home was stolen and her personal possessions stolen or destroyed. She is now trying to cope with all the same delimmas that most sane persons pull their hair out over. This has cost her and the community hundreds of thousands of dollars that she doesn't have and a tangled nest of legal issues where reality can't be separated from fantasy. It's a nightmare! The bad guys are still out there assaulting her finances and credit because the law has no way to protect her. The local government took advantage of her mental incapacity to leverage her out ot the title to her home through code enforcement fines and a community development grant that they misled her into believing that she would never have to pay back. Take her situation times the millions of others in a similar state of mind and you're talking about some serious money. All the properties that the bad guys entangled in her name is going to have to go to court several times over inorder to get the titles cleaned up so that somebody can buy, sell or use them. Debts were acquired all over several states, and continue to accumulate, which impacts every one of those creditors. We need a pragmatic approach to this problem which goes beyond just somebody being jailed. An ounce of prevention here could go a long ways. John H.