State Mental Health Agency Expenditures and Violent Crime: Implications for Public Policy

To investigate whether state mental health agency spending is associated with reductions in violent crime rates, with an emphasis on crimes committed with firearms.

Findings show a modest impact on aggravated assaults from community mental health expenditure, but these should be taken within the context of how the variables are defined. For community mental health spending in New Jersey, for instance, approximately $1billion is spent on community mental health expenditure each year. This suggests that a 10% increase in community mental health expenditure would equate to $100M. Policymakers would need to decide if such an investment is warranted to reduce the number of aggravated assaults by 1.4% (0.35 per 100,000 or approximately 30 aggravated assaults with a firearm, annually). However, these results suggest that the value of investments in community mental health expenditure are often under-reported. Community mental health services are valued for the benefits to those with mental health conditions and their families, but our work highlights the additional benefit of community mental health programming. While we do not recommend that states employ community mental health as a primary focus for reducing gun violence, states should consider the additional benefit described here when determining levels of community mental health expenditure.

The Center found that key predictors of state community mental health spending were strongly associated with the political party of the state’s governor, the amount of Medicaid spending in the state, and the proportion of the state over the age of 65. Each of these factors is predictive of spending per capita on community mental health and had little association with rates of violent crime. This allowed us to create a model with a predicted level of community mental health expenditure that was not affected by crime rates, thus addressing the problem of reverse causality. We found that a 10% increase in community mental health expenditure is associated with a 1.4% decrease in aggravated assaults. By comparison, we calculated that states that reduced their high school dropout rate by 10 percent could see a 6.8% reduction in the rate of aggravated assault committed with a firearm. Increased inequality was also associated with increased rates of aggravated assault with a firearm. A one-unit increase in inequality as measured on the Atkinson index was associated with a 2.3% increase in the rate of aggravated assaults with a firearm. An increase in proportion of the population married of 1% was associated with a 4.8% increase in aggravated assaults with a firearm, suggesting correlations with the region (regional indicators were originally included in the model but were dropped due to correlations with other variables). Additionally, the requirement for concealed carry permit holders to pass a background check was associated with a 9.95% decrease in aggravated assaults with a firearm.

Project Status:
Completed Report

Principal Investigator (PI):
John Palatucci, Doctoral Student, School of Public Health, Rutgers Biomedical and Health Sciences, Rutgers—New Brunswick