No abstract

No abstract

Advance directives are legal documents that formalize consumer psychiatric care preferences. This article examines the statutes and goals of US psychiatric advance directives within the framework of consumer self-determination, a priority in national mental health reform. It seeks to distinguish between state models based on the degree that consumer rights are integrated into advance directive statutes and goals. The data set contains information from legislative statutes and goals from the 24 US states that enacted explicit psychiatric advance directive regulations prior to 2006. Researchers grouped the data into categories based on the similarities in consumer self-determination. The findings include an examination of the spectrum of consumer self-determination in US advance directive statutes along with a comparison of the gaps between intent and policy in state statutes.

Case managers mobilize family networks to care for patients. Family medical leave can be a resource for case managers who seek to enhance resilience among family caregivers. The Family Medical Leave Act, passed in 1993, was the first U.S. policy to regulate employee leaves from work for family care purposes (29 CFR 825.102). This policy offers family caregivers increased flexibility and equality. Current and emerging policies also can reduce financial strain. The discussion examines how case managers can integrate family medical leave into best-practice models to support patients and family caregivers.

In October of 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act became a law. It represents a groundbreaking change in substance abuse treatment policy because it redistributes the bulk of costs for substance abuse treatment from the federal government to group health plans. The law required that employee and public insurances that cover health or surgical care also provide comparable terms of coverage and treatment limitations for substance abuse. This article considers shift within the context of a popular substance abuse motto that "reform is progress but not perfect." Specifically, it examines policy implications and their impact on consumers, insurers, providers, and case managers.