Court ordered "treatment" can be much, much cheaper. When we decide somebody is not criminally culpable and shouldn't be punished for their behavior, well, we just don't necessarily have to go all medical about it.
I have a client, "Mr. D", who was found not-guilty-by-reason-of-insanity (NGRI) for burglary. He's been in the Elgin state nuthouse for a year or so, with various conflicting diagnoses of mental disorder which have justified about a dozen different psychotropic meds. It's just complex as all hell. The guy nearly died from drug side effects at least once. He's young - early twenties - and never had any life threatening health problems before he was psychiatrically "treated". His family is upset with the nuthouse doctors, and litigious. His sister's a pharmacist, so she's not easy to control with PR about medicine. DHS clearly wants this patient out as soon as they can talk his judge into a conditional release. All their clinical expertise is devoted to just stabilizing him for a few months, just making him look good enough to get past the court so they can be rid of him before he becomes their disaster.
Dr. C at Elgin, who took over from Dr. H, after this patient returned from an emergency hospital admission for acute renal failure, asked me one day whether I "believe in" any kind of medications at all. The question presumed of course that I don't "believe in" psychotropic meds. I refrained from laughing, and told him I had occasionally been highly impressed by the efficacy of ibuprofen for shingles. I also said I really have no principles against psychotropics as restraint, if someone is immanently threatening violence. There's nothing fraudulent about that, no betrayal or pretense of help.
But I pointed out that trying to fine-tune somebody's brain chemistry to improve his behavior is a ridiculously complex, expensive and unlikely enterprise. Mr. D is a perfect demonstration. Dr. C was very relieved about recent tests showing medication blood levels better than he expected, because such results should look very positive to Mr. D's court when it is asked to grant his conditional release.
In my experience judges don't know the significance of blood levels of meds any better than they know schizophrenia from schizo-affective, and that is not at all. Dr. C and the Elgin nuthouse have this whole ornate operation going which nobody really understands, and which Illinois taxpayers finance only because they automatically believe in all things medical and think there's no other choice.
At the moment I don't recall the exact amount of the budget deficit Illinois is running. But I know the daily expense of involuntary psychiatric confinement is about $400/person/day. That probably means we spend $350 million annually to keep guys like Mr. D in institutions like Elgin.
Now, what do you know! Maybe Mr. D should have been run around a quarter-mile track for an hour or so every day rather than fed neuroleptic poisons. It would have been much, much cheaper, and it might have worked at least as well for the purposes of the court and community safety, not to mention Mr. D's health.
Another implication: forensic psychiatry has been a major rip-off. The state has been wasting our tax money on a mad-science, vaguely perverted fantasy. The current and prevailing tradition in Illinois suggests somebody should go down for that....