Serious Mental Illness and Homelessness

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 America
• What the ideal mental health care can look like for individuals with serious mental illness, substance abuse treatment, and navigating homelessness
• The siloed nature of services at present
• The importance of consistent engagement and familiarity
• Recovery-oriented and person-centered care
• The importance of self-directed care
• Wraparound services
• The importance of engaging people with lived experience
• Culturally responsive services
• The current laws protect autonomy without the means to support people without capacity
• The bureaucracy that is keeping people from getting the services they need
• Changes to Laura’s Law and LPS Act that are needed to better serve individuals with grave disability or require conservatorship
• Engagement, rights, and how to better serve individuals
• Assisted Outpatient Treatment – how it can be best utilized and most effective
• The ability to shift things through budget and regulatory changes
• The understanding that current caseloads that are too high and the need to add resources
• Alternatives to long term conservatorship
• The willingness to invest in services and solutions
• Balancing the tension between self-advocacy/self-determination versus providing care
• Mental Health Advanced Directives as a tool to help with making these decisions
• Who can and should be at the table in making these decisions
• The desire to invest in people to provide services
• Whether to invest and how to assess efficacy
• The problem of the fragmented systems and communication about mental health advanced directives
• The importance of education for people needing and providing care on the options
• Looking at the benefits and “selling” the positive elements of assisted treatment
• Letting clinicians do clinical work – why that’s important and ideas of how to make it work
• Tracking outcomes effectively while diminishing bureaucracy
• Looking at the most effective goals and outcomes for clients
• Looking at unfunded mandates and how to support therapists and clients to get services without so much paper pushing and complicated outcomes
• Having service providers at the table to create the programs effectively
• Results-driven metrics and payment (the pros and cons)
• Addressing policy and stigma
• Looking at the problems with the current process for services and conservatorship
• Ideas for redirecting funding and working in collaboration with law enforcement
• How to take part in these efforts and weigh in on legislation, especially early in the process
• Our reflections on the interviews and the next steps