Costs of caring for persons with long-term mental illness in alternative residential settings

Costs for severely mentally disabled persons receiving housing subsidies and/or case management services or who are in a state hospital were compared in two suburban and rural Ohio counties. Costs assessed included housing, mental health services, medical services, dental services, personal consumption, and total costs. Costs for groups consisting of 16 clients with subsidized housing and intensive case management, 24 with subsidized housing and nonintensive case management, 11 with nonsubsidized/intensive, 11 with nonsubsidized/nonintensive, and 20 with subsidized/treatment team clients were compared with aggregate costs for state hospital patients. Costs were adjusted for differences in client characteristics between groups. Results indicated that in the areas of housing costs, mental health costs, personal-consumption costs, and total costs, there were statistically significant differences among the five community-based groups. More dramatic, total operating costs for the state hospital were at least three times as high.