The effects of reductions in public psychiatric hospital beds on crime, arrests, and jail detentions of severely mentally ill persons Public Deposited

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  • March 22, 2019
  • Yoon, Jangho
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
  • This dissertation analyzed the effect of reduced psychiatric bed supply on criminal justice outcomes. Three studies were conducted. The first two studies - Study 1 and Study 2 - explored the relationships between the supply of hospital psychiatric beds and the number of crimes, arrests, and jail inmates, using state-level panel data on 50 U.S. states and the District of Columbia for the years 1982 to 1998. There was no evidence of the relationship between the total number of psychiatric beds and these criminal justice outcomes. However, hospital type was found to have differential effects on the criminal justice outcomes. A decrease in public psychiatric hospital beds was found to increase both violent and property crimes. In contrast, an increase in private psychiatric hospital beds appears to increase property crimes. Decreased public psychiatric hospital beds also negatively affected arrests for serious property crimes and drug violations as well as the number of jail inmates. Study 3 of this dissertation analyzed the impact of the supply of hospital psychiatric beds on an individual's likelihood of jail detention among persons with severe mental illness, rigorously exploring mechanisms by which reduced psychiatric bed availability would increase jail detention. The empirical analysis was based on unique longitudinal data that provide information on the use of the mental health and substance abuse treatment systems as well as the jail system in King County, Washington over the periods July 1993 through December 1998. A decrease in total psychiatric beds was found to increase the probability of jail detention among persons with mental illness - in particular black women with severe mental illness - mainly via an increase in minor offenses. Importantly, mental health service use and substance abuse were identified as the main pathways by which decreased psychiatric bed availability increases jail detention among persons with severe mental illness. A synthesis of findings reassures the importance of close, continuous communication and collaboration within and across sub-systems of a community including the inpatient mental health system, the outpatient mental health system, the substance abuse treatment system, and the criminal justice system.
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  • Domino, Marisa
Degree granting institution
  • University of North Carolina at Chapel Hill
  • Open access

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