Adult Mental Health

Investing in effective programs and services for adults with mental health and substance use disorders benefits program participants and the state. Programs that reduce the prevalence and severity of mental health conditions generate positive outcomes including higher employment and earnings, lower crime, reduced homelessness, and lower healthcare costs.

The NC Results First Initiative examined the effectiveness and return on investment from state-funded adult mental health programs supported by the Adult Mental Health Services Team (AMH).

  • Ten of the 26 total programs are proven effective by rigorous evidence, showing a positive impact on at least one targeted outcome. The remaining programs need additional research to confidently measure their effects.
  • Five of the programs had sufficient research evidence to estimate the return on investment the state can expect if the programs are implemented according to the core design and delivery elements from the research. All five programs are proven to generate positive outcomes for participants.

Program Effectiveness and Return on Investment Findings

Program -$Costs +$Benefits Net Impact Benefit: Cost Ratio Percent Confidence
Individual Placement and Support (IPS) -$4,369 $11,163 $6,793 $2.55: 1  96%
Peer Support Services -$3,992 $4,767 $775 $1.19: 1 65%
Resource Intensive Comprehensive Case Management (RICCM) -$4,203 $11,819 $7,616 $2.81: 1 49%
Critical Time Intervention (CTI) -$6,983 $2,172 -$4,812 $0.31: 1 29%
Mobile Crisis Management: Low Risk Adult Offenders -$998 $4,477 $3,480 $4.44: 1 86%
Mobile Crisis Management: General Population -$998 $645 -$352 $0.64: 1 16%

Table Note: Costs and benefits are presented in 2020 dollar values. Future costs and benefits are discounted using a 3.5% discount rate.

Return on Investment Findings

IPS, Peer Support Services, and RICCM show a positive return per dollar spent on these programs.

While research shows CTI effectively reduces homelessness among individuals with serious mental illness, this primary outcome could not be monetized. Therefore, this analysis only provides a partial comparison of CTI’s costs and benefits.

Mobile Crisis Management (MCM) generates a high return on investment when delivered to criminal justice-involved individuals because of the program’s effect on crime reduction. Program costs outweigh the expected benefits for a general population.

Available Reports


Total Costs: Costs reflect the immediate expenses that the state incurs from delivering the program to one person.

Total Benefits: The long-term, monetized benefits from reducing the likelihood of recidivism among high-risk juveniles include avoided crime victimizations, lower justice system costs, and higher education and earnings for participants. When applicable, the estimated benefits also include the avoided costs from the “usual” treatment – the services the individual would have otherwise received.

Net Impact: The per-person benefits minus the costs of program delivery provides a measure of return-on-investment. It answers, “How much better off is North Carolina from investing in this program?” 

Benefit-Cost Ratio: Another measure of return-on-investment, the benefit-cost ratio presents the benefits generated per dollar spent on the program. 

Confidence: The confidence metric is the percentage chance that the program will yield positive net benefits. To test the sensitivity of the results to variations in key estimates, this analysis simulated the benefits and costs 10,000 times, varying model inputs within a reasonable range.