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An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure

Published online by Cambridge University Press:  01 September 2022

S. Loubiere ,
A. Tinland ,
T. Bosetti  and
P. Auquier
S. Loubiere*
Affiliation:
APHM, Service Epidemiologie And économie De La Santé, Direction De La Recherche, MARSEILLE, France
A. Tinland
Affiliation:
APHM, Marss, Marseille, France
T. Bosetti
Affiliation:
Medecins du Monde, Ailsi, Marseille, France
P. Auquier
Affiliation:
APHM, Service Epidemiologie And économie De La Santé, Direction De La Recherche, MARSEILLE, France
*
*Corresponding author.

Abstract

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Introduction

People with severe psychiatric disorders (SPD) who experience housing vulnerability have to negotiate discontinuous mental health care pathways including poor access to common rights services and an increased risk of incarceration. To reduce morbidity and improve social integration of these people, Médecins du Monde (NGO), in association with the Ministry of Justice and APHM, is piloting the experimentation of an alternative to prison through assertive community treatment (ACT) and independent housing for people with SPS without housing who are referred to the court for immediate appearance.

Objectives

The main objective is to evaluate the effectiveness of the innovative program (AILSI) compared to usual services by assessing the duration of re-incarceration at 18 months of follow up.

Methods

The AILSI project has been certified as a Social Impact Bond, in which private investors support the program, with the guarantee that the French government will reimburse the investments if social impact outcomes are met. To measure the effectiveness and efficiency of the program, a randomized controlled study was designed: 100 patients will be included in the AILSI group (intervention) and 120 in the TAU group (usual services). Four social impact outcomes are identified: inclusion rate, signed leases rate, total length of re-incarceration and total resource use. It is a mixed quali-quanti research, which integrates a matching to administrative health and judicial databases.

Results

Inclusions are ongoing.

Conclusions

The AILSI program and the research methods used are described herein. In addition, detailed information on the limitations and strengths of the SIB system are also discussed.

Disclosure

No significant relationships.

Keywords

Social Impact ContractIncarcerationhousing insecuritySevere Mental Disorders
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S758 - S759
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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