Jiann-Ping Hsu College of Public Health, Georgia Southern University, Hendrix Hall, Statesboro, GA 30460-8015, USA.
Soc Sci Med. 2011 Feb;72(4):447-55. doi: 10.1016/j.socscimed.2010.07.023. Epub 2010 Aug 5.
There is a strong connection between the mental health and criminal justice systems. This research empirically tested whether the privatization of the inpatient mental health system alters this relationship, contributing to jail population growth. Using state-level panel data on U.S. states and the District of Columbia for the years 1985-1998, this study analyzed the relationship between the size of jail populations and private share of hospital psychiatric beds, first for overall private beds and then separately by private for-profit and nonprofit. Empirical models controlled for changes in mental health financing and resources, variations in criminal justice practice, and demographic and socio-economic factors as well as state and year fixed effects. A method of instrumental variables was employed to make a stronger case for causal inference. Results show that a one-percentage point increase in the private for-profit share of psychiatric beds contributes to the growth of jail inmates by approximately 2.3% annually. A greater private nonprofit share of psychiatric beds does not appear to influence the size of jail populations. These findings suggest that the increased private for-profit share of inpatient psychiatric resources undermines the safety-net and some control function of the mental health system and leads to a greater number of jail inmates.
心理健康和刑事司法系统之间存在着紧密的联系。本研究从实证角度检验了精神卫生系统的私有化是否改变了这种关系，从而导致监狱人口增长。本研究使用了 1985 年至 1998 年美国各州和哥伦比亚特区的州级面板数据，分析了监狱人口规模与医院精神科病床私立份额之间的关系，首先分析了整体私立病床的关系，然后分别分析了私立营利性和非营利性病床的关系。实证模型控制了精神卫生融资和资源的变化、刑事司法实践的差异，以及人口和社会经济因素以及州和年份的固定效应。采用工具变量法来更有力地证明因果关系。结果表明，私立营利性精神科病床份额每增加一个百分点，监狱囚犯人数每年大约增加 2.3%。私立非营利性精神科病床份额的增加似乎并没有影响监狱人口规模。这些发现表明，精神科住院资源中营利性私立份额的增加破坏了精神卫生系统的安全网和一些控制功能，导致监狱囚犯人数增加。
