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Cited by 40Criminal Justice and Corrections AnalysisHealthcare Policy and ManagementMental Health Treatment and Access

Expedited Medicaid Enrollment, Mental Health Service Use, and Criminal Recidivism Among Released Prisoners With Severe Mental Illness

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Morrissey, Joseph P., Domino, Marisa E., Cuddeback, Gary S.·2016·Psychiatric Services
DOI 10.1176/appi.ps.201500305PMC PMC4969154
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Abstract

OBJECTIVE: This study investigated whether Washington State's 2006 policy of expediting Medicaid enrollment for offenders with severe mental illness released from state prisons increased Medicaid access and use of community mental health services while decreasing criminal recidivism. METHODS: A quasi-experimental design with linked administrative data was used to select all prisoners with a severe mental illness (schizophrenia or bipolar disorder) released during the policy's first two years (January 1, 2006, through December 31, 2007), and those referred for expedited Medicaid (N=895) were separated from a propensity-weighted control group of those not referred (N=2,191). Measures included binary indicators of Medicaid enrollment, other public insurance enrollment, postrelease use of inpatient and outpatient health services, and any postrelease criminal justice contacts. All data were collapsed to person-level observations during the 12 months after the index release, and outcomes were estimated via propensity-weighted logit models. RESULTS: Referral for expedited Medicaid on release from prison greatly increased Medicaid enrollment (p<.01) and use of community mental health and general medical services (p<.01) for persons with severe mental illness. No evidence was found that expediting Medicaid reduced criminal recidivism. CONCLUSIONS: Expediting Medicaid was associated with increased Medicaid enrollment and both mental health and general medical service use, but study findings strongly suggest that rather than relying on indirect spillover effects from Medicaid to reduce criminal recidivism, advocates and policy makers would better address the needs of offenders with severe mental illness through direct interventions targeted at underlying causes of recidivism.

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  • Emergency room use increased in the intervention group compared to services as usual (55% vs. 35%, p < .01).

    “emergency room use (55% vs. 35%, p < .01)”

    From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [80]

  • Unexpectedly, a significantly greater proportion of the intervention versus comparison group spent any days in jail (43 vs. 34%, p < .01) and state prison (56% vs. 46%, p < .01), with no significant difference in the proportion with any arrests (59% vs. 54%).

    “Unexpectedly, there was a significantly greater proportion of those in the intervention versus comparison group that spent any days in jail (43 vs. 34%, p < .01) and state prison (56% vs. 46%, p < .01), with no significant difference in the proportion with any arrests (59% vs. 54%) at follow-up.”

    From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [80]

  • Outpatient primary care use increased in the intervention group compared to services as usual (64% vs. 42%, p < .01).

    “outpatient primary care (64% vs. 42%, p < .01)”

    From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [80]

  • Community mental health use increased in the intervention group compared to services as usual (69% vs. 37%, p < .01).

    “Community mental health (69% vs. 37%, p < .01)”

    From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [80]

  • In Washington State, 12 months post-implementation, 81% of the expedited Medicaid group and 43% of the services as usual group were enrolled in Medicaid (p < .01).

    “Twelve months post-implementation, 81% of the expedited group and 43% of the services as usual group were enrolled in Medicaid, (p < .01).”

    From Community Interventions to Promote Mental Health and Social Equity (2019) · cites this paper as [80]

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Authors
Morrissey, J. P., Domino, M. E., & Cuddeback, G. S.
Affiliations
University of North Carolina at Chapel Hill (US)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2016-08-01
Volume
67
Issue
8
Pages
842-849
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/appi.ps.201500305
PMC
PMC4969154
OpenAlex
W2340610699
Cited by
40
References
29
Citations by year
2026: 4 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 8 · 2021: 3 · 2020: 5 · 2019: 6 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 1
FWCI
11.41
Type
journal article
Language
en
Open access
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH086232)
Topics
  • Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
severe mental illness, released prisoners, recidivism, community mental health services, schizophrenia, bipolar disorder, Washington State
MeSH terms
Recidivism, Adult, Bipolar Disorder, Community Mental Health Services, Female, Humans, Male, Medicaid, Prisoners, Schizophrenia, United States, Washington

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