People with mental illnesses are over-represented in the criminal justice system, which increases public safety costs to taxpayers.
Deflection programs can reduce initial criminal justice involvement for individuals with substance use disorders or mental illnesses.
Mental health and crisis response programs are associated with financial savings for states; however, there is limited research on how investing in these programs impacts public safety costs.
Police regularly arrest and jail detainees with substance use disorder (SUD) and mental health crises (DPS 2019). As a result, mental illnesses are overrepresented in the criminal justice system compared to the general population, which can increase public safety costs for local and state governments (see our Science Note on Mental Health and Reincarceration).
Missouri has about 23,000 prisoners, each costing about $34,000 per year (NIC 2020).
Deflection programs are collaborations between law enforcement and healthcare services to prevent people with mental illnesses from entering the criminal justice system. These include crisis teams, call centers, and co-responder models (teams including both police officers and mental health professionals) which align appropriate healthcare needs for mental illnesses and help reduce the burden on criminal justice systems (NCSL 2022).
There are five deflection pathways outside of traditional law enforcement:
The presence of SUD treatment facilities and health and community-oriented nonprofits are associated with lower local crime rates and financial savings to municipal governments (Bondurant et al. 2018, Sharkey et al. 2017).
25 states have deflection programs in place, although the programs and funding mechanisms vary widely by state (Figure 1; NCSL 2022). A full list of deflection programs and their funding mechanisms by state can be found here.
It is unclear whether there are financial savings from reappropriating funding from public safety to mental healthcare. However, there is evidence that deflection programs can lead to state savings in some cases. Interventions that include non-police support may reduce costs to municipalities and states compared to police intervention (Marcus & Stergiopoulus 2022).
MO’s Justice Reinvestment Initiative (JRI) aims to address behavioral and mental healthcare needs by collaborating with the MO Dept. of Mental Health, HealthNet, Behavioral Health Council, and the Trauma Initiative. JRI-associated programs can be found in Supplemental Table 1. JRI impacts on imprisonment rates are still unclear (DOC 2021).
See our Science Notes on Behavioral Healthcare Deficits and Interventions and Behavioral Health Crisis Response Strategies for more information.
Bondurant, S. R., Lindo, J. M., & Swensen, I. D. (2018). Substance abuse treatment centers and local crime. Journal of Urban Economics, 104, 124-133. Substance Abuse Treatment Centers and Local Crime (nber.org)
Bronson, J., & Berzofksy, M. (2017). Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011-12. Bureau of Justice Statistics of the U.S. Department of Justice. Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011-12 (ojp.gov)
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Jácome, E. (2020). Mental health and criminal involvement: Evidence from losing medicaid eligibility. Job Market Paper, Princeton University. Jacome_JMP.pdf (elisajacome.github.io)
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Legislative Analysis and Public Policy Association. (2021). Deflection programs: Summary of State Laws. Deflection Programs - Summary of State Laws (legislativeanalysis.org)
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Marcus, N., & Stergiopoulos, V. (2022). Re‐examining mental health crisis intervention: A rapid review comparing outcomes across police, co‐responder and non‐police models. Health & Social Care in the Community, 30(5), 1665-1679. Re‐examining mental health crisis intervention: A rapid review comparing outcomes across police, co‐responder and non‐police models - Marcus - 2022 - Health & Social Care in the Community - Wiley Online Library
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https://nij.ojp.gov/topics/articles/measuring-recidivism.
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