MAPping Los Angeles County: Taking an Evidence-Informed Model of Mental Health Care to Scale

2013 ◽  
Vol 43 (2) ◽  
pp. 190-200 ◽  
Author(s):  
Michael A. Southam-Gerow ◽  
Eric L. Daleiden ◽  
Bruce F. Chorpita ◽  
Christine Bae ◽  
Cricket Mitchell ◽  
...  
CNS Spectrums ◽  
2019 ◽  
Vol 25 (5) ◽  
pp. 561-565 ◽  
Author(s):  
Kristen Ochoa ◽  
Oona Appel ◽  
Viet Nguyen ◽  
Elizabeth Kim

Los Angeles County’s Office of Diversion and Reentry (ODR) has removed over 3800 people from the largest jail system in the country. Across various diversion programs, ODR’s fundamental goal is to provide permanent, lifetime care for each diverted person. This article describes ODR’s various diversion programs, and elucidates the types of elaborate clinical and court-related interventions that are necessary to remove persons with serious mental disorders from jail custody. As Los Angeles continues to build the necessary community-based continuum of mental health care, ODR’s model proves that thoughtfully removing persons with serious mental disorders from jail is possible and necessary for the health of both patients and community.


2019 ◽  
Vol 84 (4) ◽  
pp. 664-689 ◽  
Author(s):  
Neil Gong

How do public safety net and elite private mental health providers cope with a key dilemma since psychiatric deinstitutionalization—managing madness when people have the right to refuse care? I observed two approaches to voluntary community-based services, one that tolerates “non-compliance” and deviant choices, and another that attempts to therapeutically discipline clientele. The puzzle, given theories of the paternalistic governance of poverty, is that select poor patients are given autonomy while the privileged are micro-managed. Drawing on comparative fieldwork in Los Angeles, I show how contrasting ecological pressures and resource bases shape divergent practices. In the context of urban poverty governance, mental health care and low-barrier housing offer a way to remove problem people from public space. This “tolerant containment” is linked to limited therapeutic capacity and the construction of clients as beyond transformation. In the context of family systems governance, elite private mental health care is a project to reform wayward relatives and equip them with respectable futures. A “concerted constraint” of deviance, akin to Lareau’s theory of privileged childrearing, is reserved for those who can afford rehabilitation and conceivably recover. Using these cases, I contribute to theories of social control and inequality in advanced liberal societies.


1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.


2020 ◽  
Author(s):  
Nosheen Akhtar ◽  
Cheryl Forchuk ◽  
Katherine McKay ◽  
Sandra Fisman ◽  
Abraham Rudnick

2012 ◽  
Vol 28 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Sabine Loos ◽  
Reinhold Kilian ◽  
Thomas Becker ◽  
Birgit Janssen ◽  
Harald Freyberger ◽  
...  

Objective: There are presently no instruments available in German language to assess the therapeutic relationship in psychiatric care. This study validates the German version of the Scale to Assess the Therapeutic Relationship in Community Mental Health Care (D-STAR). Method: 460 persons with severe mental illness and 154 clinicians who had participated in a multicenter RCT testing a discharge planning intervention completed the D-STAR. Psychometric properties were established via item analysis, analyses of missing values, internal consistency, and confirmatory factor analysis. Furthermore, convergent validity was scrutinized via calculating correlations of the D-STAR scales with two measures of treatment satisfaction. Results: As in the original English version, fit indices of a 3-factor model of the therapeutic relationship were only moderate. However, the feasibility and internal consistency of the D-STAR was good, and correlations with other measures suggested reasonable convergent validity. Conclusions: The psychometric properties of the D-STAR are acceptable. Its use can be recommended in German-speaking countries to assess the therapeutic relationship in both routine care and research.


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