Serious Mental Illness and Homelessness
An interview with California State Senator Henry Stern and Dr. Curley Bonds, Chief Medical Officer for Los Angeles County Department of Mental Health about legislation and programmatic changes needed to better serve highly vulnerable individuals. Curt and Katie talk with both Senator Stern and Dr. Bonds about the limitations of Laura’s Law and the Lanterman-Petris-Short Act as well as the hope for stronger, more collaborative mental health initiatives for individuals grappling with serious mental illness and homelessness. We talk about the practical funding and workforce concerns as well as how to fix them while also supporting mental health professionals.
Curley L. Bonds, M.D., oversees all clinical practices for the Los Angeles Country Department of Mental Health (LACDMH) as well as the full range of programs that function to engage and stabilize clients by bringing them into the Department’s community-based system of care.
In this episode we talk about:
Continuing our special series on Fixing Mental Healthcare in AmericaWhat the ideal mental health care can look like for individuals with serious mental illness, substance abuse treatment, and navigating homelessnessThe siloed nature of services at presentThe importance of consistent engagement and familiarityRecovery-oriented and person-centered careThe importance of self-directed careWraparound servicesThe importance of engaging people with lived experienceCulturally responsive servicesThe current laws protect autonomy without the means to support people without capacityThe bureaucracy that is keeping people from getting the services they needChanges to Laura’s Law and LPS Act that are needed to better serve individuals with grave disability or require conservatorshipEngagement, rights, and how to better serve individualsAssisted Outpatient Treatment – how it can be best utilized and most effectiveThe ability to shift things through budget and regulatory changesThe understanding that current caseloads that are too high and the need to add resourcesAlternatives to long term conservatorshipThe willingness to invest in services and solutionsBalancing the tension between self-advocacy/self-determination versus providing careMental Health Advanced Directives as a tool to help with making these decisionsWho can and should be at the table in making these decisionsThe desire to invest in people to provide servicesWhether to invest and how to assess efficacyThe problem of the fragmented systems and communication about mental health advanced directivesThe importance of education for people needing and providing care on the optionsLooking at the benefits and “selling” the positive elements of assisted treatmentLetting clinicians do clinical work – why that’s important and ideas of how to make it workTracking outcomes effectively while diminishing bureaucracyLooking at the most effective goals and outcomes for clientsLooking at unfunded mandates and how to support therapists and clients to get services without so much paper pushing and complicated outcomesHaving service providers at the table to create the programs effectivelyResults-driven metrics and payment (the pros and cons)Addressing policy and stigmaLooking at the problems with the current process for services and conservatorshipIdeas for redirecting funding and working in collaboration with law enforcementHow to take part in these efforts and weigh in on legislation, especially early in the processOur reflections on the interviews and the next steps