State pays high price for incarcerating mentally ill

Spurred by a new study showing the high costs of treating the mentally ill in prison, the Malloy administration is searching for ways to treat nonviolent offenders outside the prison system.

It costs Connecticut nearly double to both incarcerate and treat an offender with serious mental illnesses, compared with the price of treatment alone, according to a new academic study that analyzed social service and correction trends in 2006 and 2007.

The report, prepared by four academic institutions and the state Department of Mental Health and Addiction Services, also found that nearly half of those with mental illnesses who were incarcerated or otherwise involved with the criminal justice system were arrested for minor, nonviolent offenses.


Michael Lawlor

Gov. Dannel P. Malloy’s criminal justice policy adviser said that by continuing to search for ways to treat nonviolent offenders with serious mental illnesses outside of the prison system, Connecticut can continue to reduce its correction budget.

“Many times these people will enter the system because we really don’t have any other option,” Michael P. Lawlor said, noting that the homeless and others struggling with poverty and mental illness don’t receive any treatment until after they are convicted of a crime. “By default, the prison system becomes a new version of the state mental health hospitals.”

“Justice-involved individuals with disabling psychiatric illnesses and addiction disorders face daunting barriers to recovery and reintegration,” the report states, adding that “public mental health and substance abuse services departments, correction systems, and social welfare programs all face challenges in serving this population. … There is potential for a large cost offset if jail diversion prevents further (criminal justice) involvement.”

According to researchers, nearly one in five incarcerated adults nationwide, about 1.9 million people, suffer from a serious mental illness. And many of these individuals also face alcohol or drug addiction problems. “Many continue to cycle repeatedly through the criminal justice system,” the report states.

The study, prepared by medical and social researchers from the University of Connecticut, Yale, Duke and the University of North Carolina, used state mental health and addiction service records to identify 25,133 Connecticut residents who were treated in 2006 or 2007 for bipolar disorder or schizophrenia.

Out of that group, more than 6,900, or 28 percent, were involved with the criminal justice system during at least one of those years.

The study found the state spent an average of $18,000 per year per person on incarceration costs, and $30,000 on treatment — including stays in secured psychiatric facilities — on those involved with the criminal justice system.

By comparison, it spent an average of $25,000 per year treating those with serious mental illnesses who had not been arrested or convicted of any offense.

In other words, the state spent $338 million during the study period both to incarcerate and treat about 6,900 individuals with serious mental illnesses, and another $446 million simply to treat a group nearly three times that size — 18,229 mentally ill patients not involved with the criminal justice system.

But the study also found that 43 percent of the arrests from the criminal justice sample involved “mostly minor offenses” such as trespassing, breach of peace, driving while intoxicated, prostitution and violation of parole, researchers reported.

Those not involved in the criminal justice system tended to have fewer, but longer, stays in psychiatric hospitals than the criminal justice sample, which experienced more acute admissions of shorter duration at greater cost.

The criminal justice sample and was four times as likely to require substance abuse services, the report stated. Those who were arrested or convicted also relied more heavily on psychotropic medications, but typically only had prescriptions to cover an average of 10 months. By comparison, the non-criminal justice system had prescriptions to cover an average of 15 months.

“The Department of Correction works closely with many different state agencies such as the Department of Mental Health and Addiction Services, the Department of Social Services, and UConn’s Correctional Managed Health Care — to name a few — to provide the best care possible when the inmate is incarcerated as well as to prepare the offender to successfully return to the community,” DOC Deputy Commissioner James Dzurenda said Thursday. “Our goal is to align these inmates with the appropriate community providers and services to make sure they get the services they need to become productive, independent citizens upon their release.”

The solution to the high cost, Lawlor said, is not as simple as removing all mentally ill offenders from Connecticut’s prisons. But by expanding existing efforts to screen offenders, and to provide treatment and other support services for the problems afflicting this group, the state could continue to reduce its prison costs, he said.

Malloy and the legislature directed the Correction Department to operate this fiscal year with a $695.2 million budget, virtually unchanged from the $693.4 million the agency spent in 2010-11. And the department faces a $50 million cut in its budget in the fiscal year that begins July 1.

Lawlor cited the Judicial Branch’s jail re-interview process as an existing program that helps control costs. This program re-examines the backgrounds of those who are incarcerated while awaiting trial and in some cases reduces their bonds. In other cases, Lawlor said, these reviews identify nonviolent individuals in need of substance abuse treatment or mental health services — problems that can be addressed more cost-effectively in community-based settings than in prison.

Increasing screening efforts like this, though, would increase the state’s reliance on secured psychiatric hospital beds and on private, nonprofit community-based social services, and both could well need more funding.

“We definitely do not have enough of these” resources, he said, adding that in tough fiscal times “it’s a complicated balancing act.” Connecticut could cut its prison costs over the long haul, but might need to make some investments in other services in the short-term.

A spokesman for the Department of Correction could not be reached for comment Wednesday or Thursday.