Criminal Records of Persons Served in the Public Mental Health System

Objective: The authors examined the frequency and severity of arrests of persons served by Medicaid as well as public mental health treatment patterns before and after arrest.

Methods: A random sample of 6,624 persons was drawn from claims of the public mental health system in Los Angeles County between July 1993 and June 2001. Clients' claims were matched to criminal justice records from 1991 to 2001. Cross-tabulations and logistic regression analyses were used to examine the likelihood and seriousness of criminal involvement, as well as clients' involvement in mental health treatment around the time of the arrest.

Results: Twenty-four percent of the sample had at least one arrest over the ten-year period. Sixty-two percent of arrested individuals had as their most serious offense a nonviolent crime. Half of all observed arrests did not lead to conviction. There was no statistical difference in the total treatment services received between arrested and not-arrested individuals. Among those arrested, there was only a small difference in the likelihood of receiving treatment services before and after arrest.

Conclusions: Almost a quarter of persons with serious mental illness were arrested at least once over ten years. More than one-third of these individuals were arrested for violent crimes, with drug crimes the second most common category. The seriousness of the offense varied with diagnosis. Arrest was not associated with meaningful increases in service use, pointing to potential missed opportunities for treatment.