Mental Health in the Criminal Justice System-The Effect of Mandating Treatment for Convicted Individuals

Mental health disorders are particularly prevalent among those in the criminal justice system. Since the medical field has shown that therapy and medication can reduce symptoms of mental illness, it may be the case that mental health treatment can reduce behavioral outcomes such as crime. This project evaluates the causal impact of mandated mental health treatment on individuals' likelihood of committing a future crime. The project focuses on how being assigned mental health treatment at the time of probation impacts recidivism over the next five years. The estimation strategy exploits judge variation in court-mandated mental health treatment and data on all criminal court cases in North Carolina from 1994 to 2009. It uses the randomly assigned judge's propensity to mandate mental health treatment among other offenders as an instrument for actually being assigned mental health treatment as a term of probation. Preliminary results show that being assigned to seek mental health treatment decreases the likelihood of three-year recidivism by 5.6 percentage points, or 17 percent. The effect of mental health treatment persists over time: by five years after conviction, offenders are 7.1 percentage points or 18 percent less likely to commit new crimes. Treatment is similarly effective across most dimensions of heterogeneity, but suggestive evidence that it is more effective among Black men and individuals charged with more serious offenses. Finally, this project conducts a cost-benefit analysis considering a relatively non-targeted program offering therapy to all probationers regardless of the offense they commit or evaluations of their mental health. The effect of mental health treatment on recidivism is allowed to vary by broad offense groups and incorporate offense-specific costs of recidivism. The analysis suggests that the treatment-induced decrease in future crime would be more than sufficient to offset the costs of providing treatment. CA/NCF