Abstract
Based on the effort to develop a comprehensive and effective management system for mental health services in Los Angeles, an incentives model is proposed as a general managerial approach for any mental health organization. The successes and failures of strategies to improve a large state (California) and county (Los Angeles) mental health delivery system are reviewed and evaluated. During a six-year period ending in 1984, using an incentives approach, Los Angeles County services to the seriously mentally ill increased, staff morale improved, hospital utilization decreased, residential treatment facilities increased by six times, and high costs per unit of service fell to competitive levels. Care shifted from the hospital to the community, and regional resources were partially redistributed to become more in line with patient needs. However, severe budget cuts consumed operational economies and political resistance hampered efforts to redistribute regional resources. A radical state-level reorgenization is proposed to focus responsibility and to avoid county governance.
Similar content being viewed by others
References
California Welfare & Institutions Code: The Short-Doyle Act. Section 5600, et seq., 1957.
California Welfare & Institutions Code: The Short-Doyle Act. Section 5600, et seq., 1983.
Plan for Mental Health Services, County of Los Angeles, 1977–78–1977–80. Los Angeles County of Health Services, 1977; 2.05, 2.06.
Minutes, Special Meeting of the Los Angeles County Mental Health Advisory Board. Wednesday, November 30, 1977.
Plan for Mental Health Services. County of Los Angeles, 1978–79–1978–81. Los Angeles County Department of Health Services, 1978, 2–17.
Dohrenwend BP, Dohrenwend BS: Social Status and Psychological Disorder, A Casual Inquiry. New York: Wiley, 1969; 29–31.
Sorkin A, Weeks L, Fritag J: The Use of Social Indicators in Allocating State Mental Health Funds. Presentation at the Urban and Regional Information Systems Association Conference (URISA). Atlantic City: August, 1973.
Warheit GL: An Assessment of the Need for Mental Health and Alcohol Related Services in the State of California. Sacramento, California: Department of Mental Health, 1980.
Meinhardt K, Vega W: A Method for Estimating the Level of Underutilization of Mental Health Services by Mexican Americans and Other Minority Groups. Unpublished Manuscript, 1986.
County of Los Angeles: Short-Doyle Plan for Mental Health Services, 1984–87. Preliminary Multiyear Base Plan. Los Angeles County Department of Mental Health, 1984.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Elpers, J.R. Development and utilization of incentive systems for mental health operations: Successful and unsuccessful knowledge utilization in California and Los Angeles. The Journal of Mental Health Administration 16, 9–20 (1989). https://doi.org/10.1007/BF02522181
Issue Date:
DOI: https://doi.org/10.1007/BF02522181