“What works” for justice-involved people with mental illness

Abstract: Each year, over 2 million people with serious mental illness are booked into U.S. jails. These people typically stay longer in jail than those without mental illness—and, upon release, are more likely to be reincarcerated. Today, over 300 counties have resolved to “step up” their efforts to reduce the number of people with mental illness in jail. In this presentation, I highlight research on “what works” to reduce re-offending among justice-involved people with mental illness. Programs must avoid the traditional assumption that mental illness is the direct cause of the problem, and linkage with psychiatric services is the solution. Evidence-based, cost-effective programs look beyond psychiatric explanations to address robust risk factors that are shared by people with- and without mental illness.

"Mental health and women's choices. Experimental evidence from a Randomized Control Trial"

Abstract: We evaluate the long-term impact of treating maternal depression on women's financial empowerment and parenting decisions by exploiting experimental variation induced by a cluster-randomized control trial which provided psychotherapy to perinatally depressed mothers in rural Pakistan. The trial, which is the largest psychotherapy trial in the world, was highly successful at reducing depression rates of mothers. We relocate mothers 6 years after the intervention concluded to evaluate the effects of the intervention on women's financial empowerment, parental investments, fertility, as well as children development. We find that treating maternal depression increased women's empowerment, particularly control over spending, both in the short-run and in the long-run. Consistent with the reports of increased control over spending, we find persistent effects of the intervention on both time- and monetary-intensive parental investment. We do not find any detectable effect on children development. The long-run treatment effects are concentrated among girls.

"Does Universalization of Health Work? Evidence from Health Systems Restructuring and Maternal and Child Health in Brazil"

Abstract: We investigate restructuring of the health system in Brazil motivated to operationalize universal health coverage. Using administrative data from multiple sources and an event study approach that exploits the staggered rollout of programmatic changes across municipalities, we find large reductions in maternal, foetal, neonatal and postneonatal mortality, and fertility. We document increased prenatal care visits, hospital births and other maternal and child hospitalization, which suggest that the survival gains were supply-driven. We find no improvement in the quality of births, which may be explained by endogenous shifts in the composition of births towards higher-risk births.