Benefit-cost analysis of a modified therapeutic community for mentally ill chemical abusers

Michael T. French, Kathryn E. McCollister, Stanley Sacks, Karen McKendrick, George De Leon

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


This paper estimates and compares the economic benefits and costs of modified therapeutic community (modified TC) treatment for homeless mentally ill chemical abusers (MICAs) relative to a 'treatment-as-usual' (TAU) comparison group. Data from the period 12 months pre-admission to the modified TC were compared to data from 12 months post-admission across three outcome categories: employment, criminal activity, and utilization of health care services. The economic cost of the average modified TC treatment episode was $20,361. The economic benefit generated by the average modified TC client was $305,273. The incremental economic benefit per modified TC client (relative to TAU) was $273,698, resulting in a net benefit per modified TC client of $253,337 and a benefit-cost ratio of 13:1. Adjusting for extreme outlier observations, the incremental economic benefit estimate was $105,618, net benefit was $85,257, and the benefit-cost ratio was 5.2. These results quantify the potential economic and social advantages of the modified TC approach and highlight the policy implications of modified TC programs for homeless MICAs. This study is the first comprehensive economic evaluation of TC treatment for homeless MICAs; future research can draw from the economic analysis methods outlined here to apply to larger samples, longer follow- up periods, and other treatment settings.

Original languageEnglish (US)
Pages (from-to)137-148
Number of pages12
JournalEvaluation and Program Planning
Issue number2
StatePublished - Jan 1 2002


  • Analysis
  • Economic evaluation
  • MICAs
  • Therapeutic community

ASJC Scopus subject areas

  • Business and International Management
  • Strategy and Management
  • Public Health, Environmental and Occupational Health
  • Social Psychology
  • Education
  • Sociology and Political Science


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