(July 24, 2014) When Medicaid tries to save money by restricting access to the most effective antipsychotics for people with severe mental illness, more mentally ill people end up in jail, according to new research from the American Journal of Managed Care (“AJMC Study Finds Medicaid Barriers to the Right Drugs May Cause More with Schizophrenia to Land Behind Bars,” July 22).
The antipsychotics, called “atypical antipsychotics,” have been associated with lower rates of relapse in people with schizophrenia. Using data from 16,844 prison inmates, researchers found that restricting access to atypical antipsychotics – Medicaid must review the prescription before covering it – was associated with a 22 percent increase in the likelihood that a person with severe mental illness would end up behind bars.
“The United States spends $8.5 billion each year on persons with severe psychiatric disorders in jails and prisons,” the authors said in a statement. “The prison system is an expensive way to deal with mental illness, especially when many of those incarcerated are nonviolent.”
This study comes at a time when jails and prisons are facing increased scrutiny for their treatment of mentally ill prisoners and states are under pressure to enact policies that keep people with serious mental illness out of the criminal justice system.
This scrutiny makes sense. Criminalizing people with severe mental illness is a human rights violation and costs taxpayers money. An investigation by USA Today found that a 94-day incarceration cost $30,258, whereas a full year of housing, disability income, and treatment for a person with a serious mental illness was just $31,200.
“Limiting access to effective therapy may save states some Medicaid money in the short run,” said lead author Dana Goldman, director of the Leonard D. Schaeffer Center for Health Policy & Economics at the University of Southern California. “But the downstream consequences -- including more people in prisons and more criminal activity -- could be a bad deal for society."
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