Smart Justice for Superutilizers
The prevalence of justice-involved people with mental illness who cycle frequently among emergency rooms, hospitals, and jails – “super utilizers” – results in staggering human and fiscal costs. With funding from the Laura and John Arnold Foundation (LJAF), we are evaluating a system-wide transformation in Dallas County, Texas that will use technology and targeted services to break the cycle. Administrative databases are linked to identify and assess super utilizers in real time and assign those at lower risk of reoffending to Assertive Community Treatment (ACT) and those at higher risk to Forensic Assertive Community Treatment (FACT).
In this study, we will rigorously test the impact of this initiative. Specifically, we will randomly assign super utilizers to either services as usual or the Smart Justice case identification and assignment process. We will assess whether Smart Justice reduces incarceration, emergency care, hospitalization, and costs over a two-year period for this high risk population. Results will provide empirical guidance for constructing systems of care to respond efficiently and effectively to super utilizers.