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Cost-Savings Associated with Reductions in Public Service Utilization with Provision of Permanent Supported Housing in Midsized City in the United States

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Abstract

Severe and persistent mental illnesses are frequently associated with homelessness and extensive use of public services. Cost savings after the provision of permanent supportive housing (PSH) have been examined in large metropolitan areas but not in medium-sized communities. Administrative and clinical data were collected to determine use of public services, such as use of emergency services, inpatient psychiatric and medical services, and correctional facilities, in the year preceding and the year subsequent to placement in PSH. Costs of the housing and the utilized services were also calculated. Ninety-one subjects were in housing first (HF) programs and 19 were in treatment first (TF) programs. Overall there was a net cost savings of over $1.2 million or $6134/consumer/year of PSH. Nearly all cost savings were in reduced service utilization which implies prevention of both medical and psychiatric morbidity. In HF the average per patient cost savings ($21,082.12) was not significantly greater than TF ($12,907.29; p = 0.33). Provision of PSH in a mid-sized city provides significant cost savings.

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Acknowledgements

This work was supported by an Improved Health Outcomes Program (IHOP) grant from Passport Health Plan, Louisville, Kentucky to Wellspring. The funder has no control over the publication or the data analysis.

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Authors and Affiliations

  1. Wellspring, PO Box 1927, Louisville, KY, 40201-1927, USA

    Kathy Dobbins

  2. Family Health Centers, Inc, 712 East Muhammad Ali Blvd, Louisville, KY, 40202, USA

    Carey Addison

  3. Center for Mindfulness and CBT, 10845 Olive Blvd, St. Louis, MO, 63141, USA

    Autumn Roque

  4. College of Nursing, University of Kentucky, Lexington, KY, 40436, USA

    Peggy L. El-Mallakh

  5. Department of Psychiatry, University of Louisville School of Medicine, Louisville, KY, 40202, USA

    Rif S. El-Mallakh

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  1. Kathy Dobbins
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  2. Carey Addison
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  3. Autumn Roque
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  4. Peggy L. El-Mallakh
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  5. Rif S. El-Mallakh
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Correspondence to Rif S. El-Mallakh.

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Potential Conflicts of Interest

Dr. Rif El-Mallakh has research funding from Galen Pharmaceuticals. He is on the speakers’ bureaus of Indivior, Janssen, Otsuka, Sunovion, Takeda, and Teva. None of the other others have any potential conflicts of interest to report.

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Dobbins, K., Addison, C., Roque, A. et al. Cost-Savings Associated with Reductions in Public Service Utilization with Provision of Permanent Supported Housing in Midsized City in the United States. Psychiatr Q 92, 833–841 (2021). https://doi.org/10.1007/s11126-020-09716-7

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  • DOI: https://doi.org/10.1007/s11126-020-09716-7

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