Laura J. Dunlap

ECONOMIC COSTS OF MENTAL RETARDATION, CEREBRAL PALSY, HEARING LOSS, AND VISION IMPAIRMENT

The purpose of this study was to assess lifetime economic costs for people with four developmental disabilities (DDs): mental retardation, cerebral palsy, hearing loss, and vision impairment. Estimates were generated for direct medical costs, direct non-medical costs, and productivity losses resulting from increased morbidity and premature mortality. Findings suggest that lifetime costs, in excess of costs for individuals without DDs, are approximately

A Benefit-Cost Analysis of the Kings County District Attorney's Office Drug Treatment Alternative to Prison (DTAP) Program:

870,000 per person for mental retardation and

The costs of pursuing accreditation for methadone treatment sites - Results from a national study:

800,000 per person for cerebral palsy (in 2000 dollars). Analogous cost estimates for hearing loss and vision impairment are approximately

Lifetime Benefits and Costs of Diverting Substance-Abusing Offenders From State Prison

330,000 and

Behavioral Health Outcomes Among Adults: Associations With Individual and Community-Level Economic Conditions

470,000, respectively. Roughly four-fifths of total costs reflect productivity losses.

Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment --- United States, 2003:

In October 1990, the Kings County (Brooklyn, NY) District Attorneys Office implemented the Drug Treatment Alternative to Prison (DTAP) program to divert nonviolent felony drug offenders from prison to community-based residential drug treatment. This article presents an estimate of the costs and benefits of the DTAP program based on a cohort of DTAP participants and prison comparisons who entered treatment or prison in 1995–1996 and were tracked for 6 years. The analysis focuses on the criminal justice system (CJS) costs associated with criminal recidivism. Findings show that the DTAP program is cost-beneficial compared to the usual criminal justice process (benefit-cost ratio equals 2.17 after 6 years).

Health Care Reforms and Managed Care for Substance Abuse Services: Findings from Eleven Case Studies

The use of accreditation has been widespread among medical care providers, but accreditation is relatively new to the drug abuse treatment field. This study presents estimates of the costs of pursuing accreditation for methadone treatment sites. Data are from 102 methadone treatment sites that underwent accreditation as part of the Center for Substance Abuse Treatments evaluation of the Opioid Treatment Program Accreditation Project. The analysis represents the most comprehensive analysis of the costs of pursuing accreditation by a health care provider. Importantly, it is the first analysis of the costs of pursuing accreditation by drug treatment providers. Policy makers and drug treatment providers can use this analysis to plan the labor requirements and costs of future accreditation initiatives.

Compensating -wage differentials for job stress

Prisons hold a disproportionate number of society’s drug abusers. Approximately 50% of state prisoners meet the criteria for a diagnosis of drug abuse or dependence; however, only 10% of prisoners receive drug treatment. Diverting offenders to community-based treatment has been shown to generate positive net social benefits. We build on a lifetime simulation model of a nationally representative state prison cohort to examine diversion from reincarceration to community-based substance abuse treatment. We find that diversion provides positive net societal benefits to the United States and cost savings to the national criminal justice system. Our study demonstrates the societal gains from improving access to the community drug treatment system as an alternative to prison.

Client Choice among Standard Outpatient, Intensive Outpatient, Residential, and Inpatient Alcohol Treatment in State-Monitored Programs

OBJECTIVE This study examined the relationship between state and local economic conditions and serious psychological distress, substance use disorders, and mental health service utilization among adults in the United States. METHODS Using data from 21,100 adults who responded to the 2008-2010 National Survey on Drug Use and Health, a nationally representative survey of the U.S. civilian noninstitutionalized population living in households, the study used multivariate methods to examine associations between selected macroeconomic conditions and behavioral health outcomes. RESULTS Living in states in the top three quartiles for serious mortgage delinquency rate and in counties in the top three quartiles for unemployment rate was associated with a lower likelihood of using mental health services among individuals experiencing serious psychological distress (adjusted relative risk [ARR]=.54, .52, and .73, and ARR=.58, .62, and .71, respectively, versus quartile 1). Individual-level characteristics were the primary predictors associated with higher odds of having substance use disorders or experiencing serious psychological distress, but macroeconomic variables were not statistically significant predictors of these outcomes. CONCLUSIONS Both individual-level socioeconomic characteristics and population-level macroeconomic conditions were associated with behavioral health outcomes. Prevalence of serious psychological distress and substance use disorders and use of mental health services varied by economic measure. The findings suggest that access to and availability of mental health services for individuals experiencing serious psychological distress may be more challenging for those who do not have health insurance or who reside in regions with higher rates of mortgage foreclosures or higher rates of unemployment.