County of SAN Luis Obispo Board of Supervisors Agenda Item Transmittal (1) Department (2) Meeting Date (3)

Conclusions 3

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  Creating a Top-Level Estimate of Need • What do you think of this the overall figure of 40-60 beds per 100,000 as a standard, as reflected in the TAC’s 2008 report? Do you 36 44 of 52 Notes 15 Napolitano, Grace [@gracenapolitano], “As hospitals throughout LA County seek ways to contain the spread of 1 D. Pinals and D. Fuller, “The Vital Role of a Full Continuum COVID-19 and handle the influx of patients to be tested and of Psychiatric Care Beyond Beds,” Psychiatric Services, Vol. 71, treated, we cannot overlook the ongoing mental health crisis No. 7, 2020. unfolding during this pandemic,” Twitter post, April 28, 2020. 2 S. S. Sharfstein and F. B. Dickerson, “Hospital Psychiatry for 16 R. O’Reilly, S. Allison, and T. Bastiampiallai, “Observed the Twenty-First Century,” Health Affairs, Vol. 28, No. 3, 2009. Outcomes: An Approach to Calculate the Optimum Number of Psychiatric Beds,” Administration and Policy in Mental Health, 3 California Health Care Foundation, California Health Care Vol. 46, No. 4, July 2019. Almanac: Mental Health in California: For Too Many, Care Not There, Oakland, Calif., March 2018; and J. Sherin, Addressing the 17 Treatment Advocacy Center, homepage, undated. Shortage of Mental Health Hospital Beds: Board of Supervisors 18 E. F. Torrey, K. Entsminger, J. Geller, J. Stanley, and Motion Response, Los Angeles: County of Los Angeles Depart- D. J. Jaffe, The Shortage of Public Hospital Beds for Mentally Ill ment of Mental Health, 2019. Persons, Arlington, Va.: Treatment Advocacy Center, 2008. 4 J. Sherin, Addressing the Shortage of Mental Health Hospital 19 Organisation for Economic Co-operation and Development, Beds: Board of Supervisors Motion Response, Los Angeles: County “Hospital Beds–OECD Data,” webpage, undated. of Los Angeles Department of Mental Health, 2019. 5 M. Balfour, A. Stephenson, A. Delaney-Brumsey, J. Winsky, 20 World Health Organization, Mental Health Atlas 2017, Geneva, Switzerland, 2018. and M. Goldman, “Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies,” 21 G. de Girolamo, A. Picardi, R. Micciolo, I. Falloon, Psychiatric Services, special article, October 2021. A. Fioritti, P. Morosini, and PROGRES Group, “Residential Care 6 Substance Abuse and Mental Health Services Administration, in Italy: National Survey of Non-Hospital Facilities,” British Jour- nal of Psychiatry, Vol. 181, September 2002, pp. 220–225. Assertive Community Treatment: Building Your Program, Wash- ington, D.C.: U.S. Department of Health and Human Services, 22 J. Pirkis, M. Harris, W. Buckingham, H. Whiteford, and
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  RAND’s Outcomes-Based Approach • Dr. Richard O’Reilly, scientist at the St. • We are curious to hear feedback on RAND’s Joseph’s: Parkwood Institute and professor of outcomes-based approach, including psychiatry at Western University and at the Ȥ What do you see as the strengths and/or Northern Ontario School of Medicine shortcomings of RAND’s approach? • Dr. Debra Anne Pinals, professor of psychia- Ȥ How would you try to address these short- try, University of Michigan Medical School; comings if you were us, keeping in mind clinical adjunct professor in law, University of the limited timeframe we have? Michigan Law School; and medical director, Ȥ Are there other considerations (or sensitiv- Behavioral Health and Forensic Programs, ity analyses) we should include? Michigan Department of Health and Human
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  Conceptual Considerations Services • Dr. Elizabeth Sinclair, director of research for • Based on California’s situation, what do you the TAC. see as the most important considerations when estimating the size of the gap between psychiatric bed capacity and need? Prompts • What else might we have missed here?