Testing a strategy to stop the revolving door of hospitalization and incarceration

A small group of people with serious mental illness cycle frequently among emergency rooms, hospitals, and jails.  This “high utilization” pattern results in staggering human and fiscal costs. 

We are partnering with jails, hospitals, and community providers in Dallas, Texas to evaluate a system that leverages technology to break the cycle.  In crisis settings, people can use an analytic system that links justice and mental health databases to identify high utilizers in real time, and match them to services that match their level of clinical needs and criminogenic risk. 

This system also facilitates random assignment of people to “Smart Justice” and usual services groups.  We will assess whether Smart Justice reduces incarceration, emergency care, hospitalization, and costs over a two-year period.  Results will provide empirical guidance for constructing systems of care to respond efficiently and effectively to this high need population.

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