A system for allocating mental health resources

Leff, H. Stephen; Graves, Stephen C.; Natkins, Judith; Bryan, Jeffrey D.

doi:10.1007/bf00819235

Cited by 20 publications

(12 citation statements)

References 7 publications

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“…Lower disappearance rates for R systems, especially compared with M systems, could substantially increase service use and costs. It will be important to use these TPs in simulation models to explore how interactions between these variables affect system outcomes, service utilization, and costs over time (11,51).…”

Section: Discussionmentioning

confidence: 99%

No Magic Bullet: A Theory-Based Meta-Analysis of Markov Transition Probabilities in Studies of Service Systems for Persons With Mental Disabilities

Leff

Chow

Graves

2017

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R systems performed better than M and B systems. However, M systems did not perform better than B systems. All systems showed negative as well as positive TPs. For approximately one-third of synthesized TPs, substantial interstudy heterogeneity was noted. Associations were found between TPs and service recipient and study variables Conclusions: Conceptualizing systems as B, M, and R has potential for improving scientific understanding and systems planning. R systems appear more effective than B and M systems, although there is no "magic bullet" system for all service recipients. Interstudy heterogeneity indicates need for common approaches to reporting service recipient states, time periods for TPs, service recipient attributes, and service system characteristics. TPs found should be used in Markov simulations to project system effectiveness and costs of over time.

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Section: Discussionmentioning

confidence: 99%

No Magic Bullet: A Theory-Based Meta-Analysis of Markov Transition Probabilities in Studies of Service Systems for Persons With Mental Disabilities

Leff

Chow

Graves

2017

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“…The Mental Health/Jail Diversion Simulation Model is based on the Mental Health Simulation Model (Leff, Graves, Natkins, & Bryan, 1985; Leff, Hughes, Chow, Noyes, & Ostrow, 2010) that was developed for use in planning mental health services systems and has been in place for over two decades. The Mental Health Simulation Model has been used to plan for the introduction of evidence-based practices into ongoing systems, for estimating the costs and cost-effectiveness of transforming systems, and for identifying the implications of mental health initiatives on other systems such as criminal justice and social welfare.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…The simulation model is outcomes-based, exploring the impact of diverse service configurations on the functional-level transition of consumers on a month-to-month basis. Functional level is measured using the Resource Associated Functional Level Scale (RAFLS), a measure uniquely developed for use with the simulation model by the HSRI (Leff et al, 1985). However, any measure of functioning can be translated into the RAFLS for use in the model.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

A Simulation Modeling Approach for Planning and Costing Jail Diversion Programs for Persons with Mental Illness

Hughes

2012

Criminal Justice and Behavior

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A core public policy question for jail diversion programs, regardless of what outcomes they achieve, is whether and to what extent they generate cost savings. Apart from a general pattern of cost shifting from the criminal justice system to the community mental health system, studies on the costs of jail diversion programs have yielded limited and equivocal results. In response to the mixed results on cost findings, we tested a simulation model to project the fiscal impact of jail diversion programs using data from actual criminal justice and mental health systems and the best outcome data from the literature. Using data from Travis County, Texas, in 2006 and 2007, our simulations that produced a net savings to the county had two key findings: (a) Unless the most serious misdemeanants and low-level felons are included for diversion, there will be no cost savings since there are too few jails days avoided; and (b) the cost burden was shifted from the criminal justice system to the community-based service system, which is already strained for resources.

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“…Its specific goals are (1) to provide a structured social milieu in which to enhance patients' abilities to interact with others, (2) to provide patients with an opportunity to engage in productive activity through life skills training, (3) to train patients in life skills necessary or helpful in community living, and (4) to provide a supportive (prosthetic) environment which will enhance the capacity of patients to avoid rehospitalization. The LSP is promotive (Leff, Graves, Watkins, & Bryan, 1985) in emphasizing significant social and prevocational skills training.…”

Section: The Life Skills Program (Lsp)mentioning

confidence: 99%

“…This approach is consistent with much psychiatric day treatment conducted throughout the United States at this time. The SPM is "adaptive" in the sense of assisting patients to adjust to their present circumstances (Leff, Graves, Watkins, & Bryan, 1985) through social support.…”

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confidence: 99%