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  5. Mental Health Care and Its Impacts
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Mental Health Care and Its Impacts

Paper Session

Saturday, Jan. 3, 2026 8:00 AM - 10:00 AM (EST)

Philadelphia Convention Center, 201-A
Hosted By: American Economic Association
  • Chairs:
    Valentin Bolotnyy, Stanford University
  • Natalia Emanuel, Federal Reserve Bank of New York

A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization

Natalia Emanuel
,
Federal Reserve Bank of New York
Valentin Bolotnyy
,
Stanford University
Pim Welle
,
Allegheny County Department of Human Services

Abstract

Involuntary hospitalization is a common practice, intended to prevent individuals from harming themselves or others during a mental health crisis. We leverage quasi-random assignment of evaluating physicians in an examiner design to assess whether involuntary hospitalization achieves its objectives. For individuals whom some physicians would hospitalize but others would not, we find hospitalization nearly doubles deaths by suicide/overdose and nearly doubles being charged with a violent crime in the three months following evaluation. Potential mechanisms include earnings losses, housing disruptions, and minimal change in outpatient care utilization or medication adherence after hospitalization.

Housing First or Treatment First? Evidence from the VA's Homelessness Programs

Sydney Costantini
,
University of California-Berkeley

Abstract

Debates in homelessness policy often pit Housing First programs, in which subsidized housing is offered unconditionally and immediately, against Treatment First interventions, which combine short-term housing with treatment for issues like substance use. I study a national sample of nearly 300,000 unhoused, mentally ill Veterans who are potentially eligible for the VA’s Housing First program (known as HUD-VASH or VA Supportive Housing) or for a Treatment First program
(offered by a variety of local contractors). Using an instrumental variables design, I find that
enrolling in Housing First reduces three-year mortality by 4.6 percentage points relative to a no program counterfactual. In contrast, Treatment First has no long-term effects on health. Housing
First is also cost-saving, as it causes individuals to substitute away from lengthy inpatient stays.

The Effect of Depression on Income: Evidence from Colombia

Kaveh Danesh
,
University of California-Berkeley and University of California-San Francisco
Arlen Guarin
,
World Bank
Christian Posso
,
Banco de la República de Colombia

Abstract

Depression affects an estimated 10% of individuals worldwide and may have negative impacts on economic activity. We use nationwide administrative data from Colombia to estimate the causal impact of depression on earnings using a difference-in-differences approach that leverages cross-individual variation in the timing of major depressive episodes. Among young, formally employed workers, depressive episodes reduce earnings by 8.2%, an effect that persists for up to 24 months and is primarily mediated by the extensive margin. To further support a causal relationship between depression and earnings, we use propensity score matching to compare labor market outcomes for individuals with depression who plausibly vary only in their access to specialty care. Relative to individuals who do not access such care, those who do experience an increase in earnings which compensates for most of the income loss due to depression.
JEL Classifications
  • I1 - Health