THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF SOCIAL WORK COURSE NUMBER: COURSE TITLE, SEMESTER AND YEAR: MEETING TIME: INSTRUCTOR: OFFICE HOURS: SOWO 830 Health and Mental Health Policy Spring 2008 Monday OR Tuesday, 2:00 – 4:50 Laurie Selz Campbell, MS, CPRP 202A Tate Turner Kuralt Bldg. Phone: 843‐6394 Fax: 843‐6398 lauriesc@unc.edu Mondays and Tuesdays, 12:30 – 1:30 and by appointment COURSE DESCRIPTION: Examines national and state health/mental health policy, focusing on historical, legal, socio‐
political, and economic factors influencing financing, access, and service delivery. Explores skills/strategies for policy analysis and change. COURSE OBJECTIVES: The student who successfully completes this course should be able to demonstrate understanding of the following issues in regard to health, mental health, developmental disabilities, and substance abuse policy: 1. Discuss the historical context of contemporary health and mental health service systems and policies, including historical roots of inequality and discrimination in these systems and policies. 2. Understand specific current health and mental health policies regarding financing and legal issues such as client rights and confidentiality; explain the forces that influenced their development, their intended goals, and actual effects. 3. Explain interrelationships among health and mental health policies at the federal, state, and local levels. 4. Identify the impact of organizational structures and policies outside the health and mental health systems on the delivery of services. 5. Discuss ethical issues in health and mental health policy, including individual and family rights, issues of distributive justice, and issues of power, discrimination, and oppression in policy development. 6. Explain the ways in which current health and mental health policies affect social workers’ activities and social interventions, and ultimately the individuals and families served, with a focus on vulnerable and oppressed populations. 7. Assess the impact of and biases in health and mental health policies regarding services to individuals and families of varied race, ethnic origin, gender, socioeconomic status, sexual orientation, and other factors of difference. Identify strategies for changing policies that result in oppressive or discriminatory conditions in health and mental health. 8. Articulate both formal and informal policy development and strategies at multiple system levels. SOWO 830 Spring 09 1
9. Develop strategies for planning, developing, and changing health and mental health policies in a context of empowerment and partnership with individuals, families and communities. EXPANDED DESCRIPTION: The ability to understand the complexities of policy development and implementation is crucial for successful practice in health and mental health, as social workers shape policy, implement programs, and respond to systemic inequities. This course will examine critically a number of relevant health and mental health policies and their effects on clients, practitioners, and systems. Students who complete this course will develop the following skills: 1. The ability to assess the components of specific health and mental health policies, the different interests that are involved in shaping these policies, and the impact of the policies on social work practice and on clients. 2. The ability to identify ethical issues and personal/professional values related to the formal and informal policies affecting service delivery 3. The ability to evaluate the inter‐relationships among policies at the federal, state, local and agency levels. 4. The ability to understand and to assess the disparate impact of specific policies on individuals and families, considering different race, gender, ethnic origin, socioeconomic status, sexual orientation, and other disparities. TEXTBOOKS AND OTHER READINGS: Mechanic, D., Rogut, L. B., & Colby, D. C. (2005). Policy challenges in modern health care. Piscataway, NJ: Rutgers University Press. Rosenberg, J. & Rosenberg, S. (Eds.) (2006). Community mental health: Challenges for the 21st century. New York, NY: Taylor & Francis Group, LLC. The texts are available for purchase at the Health Affairs Bookstore. Links to additional assigned readings will be placed on the course Blackboard site under “Assignments,” and a listing of web sites containing up‐to‐date information on policies in specific domains of practice will be available under “External Links.” TEACHING METHODS AND EXPECTATIONS: Teaching methods will include lecture and class discussion, with guest lecturers for specific topics. In addition, peer learning and inquiry will be crucial components of the class. Over the course of the semester, you will have opportunities (individually, in small groups, and on “policy teams,”) to investigate issues of interest and relevance to your own practice. Full participation in these activities will be essential to your learning process in the class, and will allow you to successfully apply the course material in a way that is personally and professionally meaningful. All students are expected to attend all classes and to complete the readings before class begins. Students are expected to participate in discussions by sharing information from their reading and/or field experiences. I ask that you contact me, in advance, if you will miss a class. Any student with significant difficulty with class participation requirements should speak with me at the beginning of the semester so that alternative forms of contribution can be identified. SOWO 830 Spring 09 2
POLICIES ON THE USE OF ELECTRONIC DEVICES IN THE CLASSROOM: I expect that we will all be invested in creating a learning environment of respect and engagement. During class, cell phones should be turned off or transferred to voice mail. In addition, while I welcome the use of laptops in class for taking notes or completing small group tasks, I ask that you use them only for relevant activities – not for checking email or surfing the Web. Your attention is an important sign of respect to your colleagues, and an important part of your learning. CLASS ASSIGNMENTS: You will be graded on 3 Policy Analysis Worksheets, a policy team presentation, a peer review of another team’s presentation, and participation over the course of the semester. A summary of the assignments follows: 1. Policy Analysis Worksheets (3 worksheets @15 points apiece, for a total of 45 points): One of the most important outcomes of this class is that you develop the skills to systematically critique policies related to your practice. In order to practice these skills, you will be asked to conduct a series of systematic policy analyses using the worksheet template provided, and to make recommendations based on your analyses. 2. Policy Team Presentation (30 points): Presentations will occur during the final two classes of the semester. Shortly, we will identify policy teams consisting of 4‐5 students. Over the course of the semester, you will have time during class to meet with your teams, but you will probably also need to hold some additional meetings. For the presentation, you will select a specific, significant, policy issue affecting delivery of health or mental health services. Along with visuals (PowerPoint), you will develop a 2­page position paper building the argument for and presenting your recommendations. 3. Peer Review (10 points): Using a template that will be provided, you will critique the presentation of another policy team, identifying strengths, areas for improvement, and suggestions for accomplishing these. This is not a paper – rather you will simply fill in the table provided. The review will be due, by email, by May 1 at 5:00 pm. ** A note on participation: As described above, our class will contain a good deal of discussion and interaction. I do know that students have varying levels of comfort with speaking out in class – if this is uncomfortable for you, I hope that you will talk with me about it in confidence so that we can problem solve together about how best to maximize your participation. In addition to class discussions, you will have the chance to participate via small group activities, including synthesizing readings, working on case examples, and the like. SUMMARY OF COURSE EVALUATION COMPONENTS AND GRADING SCALE: The following summarizes the point breakdown and grading scale for the class: Policy Worksheets 45 points H: 94 and above Team Presentation 30 points P: 93‐80 Peer Review 10 points L: 79‐70 Participation 15 points F: 69 and below Total: 100 points POLICY ON INCOMPLETES AND LATE ASSIGNMENTS: Assignments are due at the beginning of class on the day noted. You must notify me at least 3 days before a due date if you would like to be granted an extension. If this does not happen, you SOWO 830 Spring 09 3
will lose 10% of the assignment’s points per day (including weekends, and including the date on which the assignment was due, if you submit it after the beginning of class). Incompletes may be granted if (a) there are extreme and unforeseeable circumstances that affect your ability to complete the semester’s work, and (b) you meet with me in advance to develop a plan and timeline for completing your work. POLICY ON ACADEMIC DISHONESTY: I assume that all students follow the UNC Honor Code. Please ensure that the Honor Code statement “I have neither given nor received any unauthorized assistance in completing this assignment”, with your signature, is on all assignments turned in. In keeping with the Honor Code, if reason exists to believe that academic dishonesty has occurred, a referral will be made to the Office of the Student Attorney General for investigation and further action as required. Please refer to the APA Style Guide, the SSW Manual, and the SSW Writing Guide for information on attribution of quotes, plagiarism, and the appropriate use of assistance in preparing assignments. POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES: If you have a disability that affects your participation in the course and you wish to receive accommodations, you should contact the University’s Disabilities Services. They will then notify me of the documented disability, and we can meet to design the appropriate accommodations to support your learning.
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ASSIGNMENT DETAILS: POLICY ANALYSIS WORKSHEETS 3 WORKSHEETS @ 15 POINTS EACH As we will discuss from the very first day of the class, health and mental health policies are shaped by a range of forces and factors. It would be ideal if policy could closely reflect what we know about evidence‐based and ethical practice, but we know that political pressure and climate, economic conditions, and the culture and realities of the practice environment also figure into the equation. In order to be an effective advocate, it is very useful to understand ALL of these forces, so that we can identify barriers to change and potential directions of influence. For each worksheet, you will choose a policy of interest to you. The following list will get you started, but is by no means exhaustive. - Access to services for undocumented immigrants (health care, education, public benefits) - Adolescent pregnancy‐related policies - Anti‐bullying legislation - Child testimony in abuse cases - Criminal insanity policies (or other issues re: competence) - Domestic violence policies (protections, child support, child custody, housing, Violence Against Women Act) - Drug legalization policies - Elder abuse - Employment policies for persons with disabilities - End‐of‐life care (advance directives, health care power of attorney, palliative care) - Ex‐offender policies (housing, employment, education, social service, child custody) - Gay/lesbian couple policies (healthcare, benefits, parenting) - “Healthy marriage” policies in federal welfare legislation - HIV/AIDS policies (housing, employment, social services, benefits) - IDEA – health or mental health services for children with special needs in school systems - Infant abandonment policies/Safe Haven laws - Migrant worker housing policies - Perinatal substance abuse policies - Sex offender registration policies - TANF/Work First policies You can also choose to focus on an issue that we discussed in class, but will complete additional reading, above and beyond what was assigned. Your Worksheet should incorporate at least five scholarly references (that is, articles from peer‐reviewed journals OR respected organizations such as the Annie E. Casey Foundation, the Urban Institute, or the Bazelon Center for Mental Health Law). The Policy Analysis Worksheet is simply a template in which you can visually organize the various factors and forces shaping a given policy, seeing how they interact, and how they provide support for, or opposition to, the policy in question. The worksheet itself contains more specific questions that can guide your reading/thinking. It can be completed in bullet points, rather than narrative form – just be sure to make your points clear and understandable, as if you were going to share your Worksheet with a legislator or policy maker. You should cite all of your sources in APA format. Stating your own opinion is fine as well (simply indicate that it is your own). SOWO 830 Spring 09 5
SOWO 830 Policy Analysis Worksheet Date: _______________________ Name: _________________________ Policy Name/Definition: What are the embedded assumptions, or implicit explanations, about how social problems are caused & how they might be best addressed? What social, political, economic, or scientific events contributed to the development of this policy? Domain Political:  Does the policy favor/disfavor any specific agendas?  Who are the major formal & informal change agents that shaped this policy? Economic  What are the short‐ & long‐term costs & benefits of the policy?  What might be some less obvious costs or benefits?  Are there particular consumers or systems that benefit economically from the policy?  Who bears the economic burden of enacting the policy & of its intended or unintended outcomes?  Are there tradeoffs between cost savings & benefits to consumers? Evidence  What evidence supports, or opposes, the policy? Is the evidence consistent?  What is the quality of the research (scope, sample, replication, design)? Is the research generalizable to all relevant populations? Ethics  What specific ethical principles (e.g. autonomy, individual rights, safety & well‐being, equality, social justice) are promoted or thwarted by the policy?  Are there dilemmas (competing or SOWO 830 Spring 09 Discussion 6
Domain contradictory principles) inherent in the policy?  Does the policy operate in a way that promotes social justice, or does it contribute to oppression/discrimination? Practice  How is the policy implemented in practice? Is it implemented as intended? If not, why might this be? Is it implemented fairly across people?  What seems to facilitate or impede effective implementation of the policy? Discussion Synthesis: In what ways do you support or oppose the policy? If you are essentially in support of the policy, what do you see as its major strengths or advantages? Are there areas in which you might improve or modify it? If you largely oppose the policy, what are the grounds on which you have made this decision? what are some of the fundamental changes that you would suggest? Citations (cite all articles or sources used in developing the worksheet):
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ASSIGNMENT DETAILS: POLICY TEAM PRESENTATION For this assignment, you will work in teams of 4‐5 students, based on similarity of interests, and will explore a significant policy or policy issue in depth. Your selection should be of sufficient magnitude that it can be traced through the scholarly literature, and evaluated across states and internationally. Your team should plan to incorporate at least 10 scholarly sources, as well as other information from websites, statistical clearinghouses, and the like. Presentations will occur during the final 2 class meetings. The presentation should be suitable for a professional policy or practice conference. In addition to visual aids, you will prepare (a) a 2­page maximum position paper summarizing the policy issue and reflecting your team’s recommendations, and (b) a citations list. You will have about one hour for the presentation, including time for questions and discussion. The following will help you to organize the presentation. POLICY ISSUE, HISTORY, AND CONTEXT: 1. Clearly identify the policy or policy issue you are discussing. Provide enough detail about the policy that your discussion will make sense to listeners who might not be familiar with it. 2. Describe the roots of the policy: Were legislative mandates, economic conditions, social pressures, and/or historical events contributing factors? STATE AND INTERNATIONAL IMPLEMENTATION: 1. Compare implementation of the policy in North Carolina and one other state. What similarities or differences do you observe? What factors (social, economic, cultural, ideological) might account for these? 2. Select one country outside the US, and describe how similar policy issues are resolved. Briefly discuss similarities and differences. What factors (social, economic, cultural, ideological) might account for these? POLICY IMPACT:** 1. What are the impacts (positive and negative) of the policy on consumers &/or families? Discuss impact on persons of varied race, ethnic origin, gender, socioeconomic status, age, sexual orientation, and/or other relevant factors of difference. Are the impacts consistent across these dimensions or are there disparities? 2. What are positive implications of the policy for providers, service systems, and the larger community? What are negative implications, or undue burdens, placed on providers, systems, or the community? ** Note: For this section, in addition to the scholarly literature, please cite at least 4 primary data sources (interviews with stakeholders which can include consumers, families, providers, administrators, or policy makers themselves) in your discussion. The preference is that you actually conduct these interviews yourselves. In certain situations, however, where this would be impossible, other first‐person accounts will work. See Laurie if you need help on this. SOWO 830 Spring 09 8
3. What research supports the effectiveness of the policy in achieving its stated aims? Is there evidence suggesting that the policy is having other than its intended effect? ADVOCACY: 1. Discuss current advocacy efforts taking place around both sides of the policy issue. What are the major arguments from each side of the issue? What strategies are employed? 2. Who are the major “movers & shakers” who keep the issue on the agenda and influence the direction that the policy takes? Describe the various stakeholder groups involved in the debate. 3. What are the major strategies utilized by the various groups to effect change? SOCIAL WORK’S ROLE & POLICY RECOMMENDATIONS: 1. Identify the possible role(s) of the social worker in effectively and ethically implementing the policy. 2. Conclude with potential recommendations for policy change that you have identified. Identify at least two specific advocacy strategies in which a social worker might engage. Your recommendations can relate to research or information gathering, stakeholder involvement and advocacy, education, and/or other ideas. 3. Discuss how you would include consumers and other stakeholders in your strategies. SOWO 830 Spring 09 9
Schedule of Classes Note: Schedule has been adjusted to reflect the January 20 (Tuesday) class that was cancelled due to adverse weather Date Readings Topics Assignment Class 1 Jan 12 Welcome to Policy  Overview of class  Getting to know each other  Reflection & small group research: How do policies persist even with compelling evidence that they are ineffective? ~ OR ~ Why are policies that are demonstrated to be effective NOT enacted? Jan 19 Martin Luther King Holiday – No class Class 2 Jan 26/27 Follow‐up to Class 1: Group reports on ineffective policies Selected Historical Highlights in Health & MH Policy Required: Goldman, H., & Morrissey, J. (1985). The alchemy of mental health policy: Homelessness and the fourth cycle of reform. American Journal of Public Health, 75(7), 727‐731. Lourie, I., & Hernandez, M. (2003). A historical perspective on national child mental health policy. Journal of Emotional & Behavioral Disorders, 11(1), 5‐9. Markel, H., & Golden, J. (2005). Successes & missed opportunities in protecting our children's health: Critical junctures in the history of children's health policy in the US. Pediatrics, 115, 1129‐1133. Stevens, R. A. (2008). History & health policy in the United States: The making of a health care industry, 1948‐2008. The Social History of Medicine, 21(3), 461‐483. Class 3 Feb 2/3 The Policymaking Process • Implicit theories of causation • Policies as moral/ethical issues • Formal & informal forces shaping the policy arena Policy focus: Mental health reform in NC as a case study Required: Mechanic Ch. 1: Morality, Politics, & Health Policy Mechanic Ch. 2: Contemporary Politics of Health Reform Rosenberg Ch. 17: Social Work in a Managed Care Environment Swartz, M., & Morrissey, J. (2003). Mental health care in North Carolina: Challenges on the road to reform. North Carolina Medical Journal, 64(5), 1‐7. (Read if you didn’t read it in last year’s policy class!) Optional: Rosenberg Ch. 19: The Uncertain Future of Public Mental Health Dickson‐Gomez, J., Convey, M., Hilario, H., Corbett, A. M., & Weeks, M. (2007). Unofficial SOWO 830 Spring 09 10
Date Topics Readings Assignment policy: Access to housing, housing information & social services among homeless drug users in Hartford, Connecticut. Substance Abuse Treatment, Prevention, & Policy, 2(8), 1‐14. Morone, J. (1997). Enemies of the people: The moral dimension to public health. Journal of Health Politics, Policy & Law, 22(4), 993‐1021. Class 4 Feb 9/10 The Policymaking Process • Agenda setting & definition • Advocacy strategies • Policy implementation • Policy success & failure Required: Choose 3 of the following articles: Burstein, P. (1991). Policy domains: Organization, culture, and policy outcomes. Annual Review of Sociology, 17(1), 327‐350. Barnes, M., Hanson, C., Novilla, L., Meacham, A., McIntyre, E., & Erickson, B. (2008). Analysis of media agenda setting during and after hurricane Katrina: Implications for emergency preparedness, disaster response, and disaster policy. American Journal of Public Health, 98(4), 604‐610. Green‐Pedersen ,M, & Wilkerson, . (2006). How agenda‐setting attributes shape politics: Basic dilemmas, problem attention and health politics developments in Denmark and the US. Journal of European Public Policy, 13(7), 1039‐1052. Lind, A. (2004). Legislating the family: Heterosexist bias in social welfare policy frameworks. Journal of Sociology & Social Welfare, 31(4), 21‐35. Nelson, B., & Johnson, N. (1991). Political structures & social movement tactics: Feminist policy agendas in the United States in the 1990s. NWSA Journal, 3(2), 199‐212. Class 5 Feb 16/17 Disability rights & consumer advocacy • History of disability rights & consumer advocacy for adults & children • Local activities/resources Required: Rosenberg Ch. 1: The Mental Health Consumer movement in the US Beaulaurier, R., & Taylor, S. (2001). Social work practice with people with disabilities in the era of disability rights. Social Work in Health Care, 32(4), 67‐91. Read primarily for reflections on how a consumer advocacy perspective might affect SW practice Slobodien, A., & O'Brien, K. (2008). The ADA Amendments Act of 2008 and how it will change the workplace. Employee Relations Law Journal, 34(3), 32‐39. Yell, M., Katsiyannis, A., & Hazelkorn, M. (2007). Reflections on the 25th Anniversary of the U.S. Supreme Court's decision in Board of Education v. Rowley. Focus on Exceptional Children, 39(9), 1‐12 SOWO 830 Spring 09 11
Date Topics Readings Assignment Optional: Burch, S., & Sutherland, I. (2006). Who's not yet here? American disability history. Radical History Review, 94, 127‐147. Read for thoughts about how social construction of disability shapes intervention Tomes, N. (2006). The patient as a policy factor: A historical case study of the consumer/survivor movement in mental health. Health Affairs, 25(3), 720‐729. Class 6 Feb 23/24 Health Insurance & Health Care Safety Net • Insurance alternatives • Innovative models of care Required: Horton, S. (2006). The double burden on safety net providers: Placing health disparities in the context of the privatization of health care in the US. Social Science & Medicine, 63, 2702‐2714. Schoen, C., Davis, K., & Collins, S. (2008). Building blocks for reform: Achieving universal coverage with private and public group health insurance. Health Affairs, 27(3), 646‐657. Review the following websites: http://www.communitycarenc.com/ http://www.ncchca.org/ In addition, choose one set of articles to read: 1. The Safety Net for Older Adults: Mechanic Ch. 13: Improving Medicare for Beneficiaries with Disabilities Policy Analysis Worksheet # 1 Karlin, B., & Duffy.J. (2004). Geriatric mental health policy: Impact on service delivery and directions for effecting change. Professional Psychology: Research & Practice, 36(5), 509‐519. 2. Mental Illness/Primary Care Integration & MH Parity: Mechanic Ch. 15: Integrating People with Mental Illness into Health Insurance & Social Services Barry, C. (2006). The political evolution of mental health parity. Harvard Review of Psychiatry, 14(4), 185‐194. 3. Children’s Insurance Coverage Issues Guendelman, S., Angulo, V., & Oman, D. (2005). Access to health care for children and adolescents in working poor families: Recent findings from California. Medical SOWO 830 Spring 09 12
Date Topics Readings Assignment Care, 43(1), 68‐78. Gyafmi, P. (2004). Children with serious emotional disturbance: the impact of poverty and receipt of public assistance on behavior, functioning, and service use. Children and Youth Services Review, 26, 1129‐1139. Optional: Mechanic Ch. 3: Employer‐based Coverage Bernick, E., & Myers, N. (2008, August). Treatment or Placebo: Are State Programs Decreasing the Proportion of Uninsured? Policy Studies Journal, 36(3), 367‐384. Clemans‐Cope, L., Kenney, G. M., Pantell, M., & Perry, C. (2007). Access to employer­
sponsored health insurance among low­income families: Who has access and who doesn’t? Washington, DC: The Urban Institute. Guendelman, S., Angulo, V., Wier, M., & Oman, D. (2005). Overcoming the odds: Access to care of immigrant children in working poor families in California. Maternal and Child Health Journal, 9(4), 351‐362. Ketsche, P., Gabel, J., & Mansfield, N. (2008, Fall2008). How does the SCHIP exclusion affect health insurance coverage for children of low income state workers? Public Personnel Management, 37(3), 313‐325. NC Department of Health & Human Services (2007). Improving access to healthcare for uninsured North Carolinians: Report to the 2007 General Assembly. Available at http://www.dhhs.state.nc.us/DMA/legis/IncrHlthCareAccessReport.pdf U.S. Bureau of Labor Statistics (2007). A profile of the working poor, 2005 (Report 1001). Washington, DC: U.S. Department of Labor. Class 7 Mar 2/3 Disparities: Origins, Explanations, Solutions Focus topics: • Racial/ethnic disparities • Disparities related to sexual orientation SOWO 830 Spring 09 Required: Rosenberg Ch. 9: Breaking the Impasse in Treatment of Oppressed Groups Mechanic Ch. 5: Fundamental Sources of Health Inequalities Mechanic Ch. 8: Patterns & Causes of Disparities Mechanic Ch. 9: Addressing Racial Inequalities In addition, choose one set of articles to read: 1. Health Disparities Affecting GLBTQ Persons: Focus on Lesbian Women Rosenberg Ch. 10: Stigma, Sexual Orientation, & Mental Illness 13
Date Topics Readings Assignment Hutchinson, M., Thompson, A., & Cederbaum, J. (2006). Multisystem factors contributing to disparities in preventive health care among lesbian women. JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(3), 393‐402. Mays, V., Yancey, A., Cochran, S., Weber, M., & Fielding, J. (2002). Heterogeneity of health disparities among African American, Hispanic, and Asian American women: Unrecognized influences of sexual orientation. American Journal of Public Health, 92(4), 632‐639 Trettin, S., Moses‐Kolko, E., & Wisner, K. (2006, March). Lesbian perinatal depression and the heterosexism that affects knowledge about this minority population. Archives of Women's Mental Health, 9(2), 67‐73. 2. Racial/Ethnic Issues: Disparities for African American Persons Rosenberg Ch. 11: African Americans & Mental Health Eliason, M. (1999). Nursing's role in racism and African American women's health. Health Care for Women International, 20(2), 209‐219. Gamble, V. N. (1997). Under the shadow of Tuskegee: African Americans & health care. American Journal of Public Health, 87, 1773‐1778. Isaac, E., Rowland, M., & Blackwell, L. (2007). Fighting health disparities: The educational role of the African American church. Cross Currents, 57(2), 261‐265. 3. Racial/Ethnic Issues: Disparities for Latino/Latina Persons Rosenberg Ch. 13: Intervention with Latino Consumers DeRose, K. P., Escarce, J. J., & Lurie, N. (2007). Immigrants & health care: Sources of vulnerability. Health Affairs, 26(5), 1258‐1268. Romero, A., Martinez, D., & Carvajal, S. (2007). Bicultural stress and adolescent risk behaviors in a community sample of Latinos and non‐Latino European Americans. Ethnicity & Health, 12(5), 443‐463. Sherrill, W., Crew, L., Mayo, R., Mayo, W., Rogers, B., & Haynes, D. (2005). Educational and health services innovation to improve care for rural Hispanic communities in the US. Education for Health: Change in Learning & Practice, 18(3), 356‐367. SOWO 830 Spring 09 14
Date Topics Readings Assignment Optional: Ashton, C., Haidet,, Paterniti, D., Collins, T., Gordon, H., O'Malley, , et al. (2003). Racial and ethnic disparities in the use of health services. JGIM: Journal of General Internal Medicine, 18(2), 146‐152. Carlos, E., & Chamberlain, R. (2004). The Black–White perception gap and health disparities research. Public Health Nursing, 21(4), 372‐379. Gamble, V., & Stone, D. (2006). U.S. policy on health inequities: the interplay of politics and research. Journal of Health Politics, Policy & Law, 31(1), 93‐126. Excellent (albeit long) article about agenda setting & health disparities work in the US Mar 9 Happy Spring Break! Class 8 Mar 16/17 Complex Policy Issues: Homelessness • Continuum of Care vs. Housing First models • Federal & State agencies involved in policy work to resolve homelessness • Specific homeless populations: - Veterans - Youth aging out of foster care - Ex‐offenders - Persons with HIV/AIDS Required: Rosenberg Ch. 14: Homeless Shelters Rosenberg Ch. 15: Effectiveness of Case Management Interventions for Homelessness Tsemberis, S., Gutcur, G., & Nakai, M. (2004). Housing first, consumer choice, & harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94(4), 651‐656. Wong, Y. I., Park, J. M., & Nemon, H. (2006). Homeless service delivery in the context of continuum of care. Administration in Social Work, 30(1), 67‐94. PLUS: Pick one of the specific populations on the left, & find two articles addressing supportive housing (particularly from policy or research evidence perspectives) for that population. In class, you will pool your information with others who have chosen the same population, & will do a mini‐presentation on policy issues & interventions. Guiding questions will be provided. Optional: Roman, C. (2004). A roof is not enough: Successful prisoner reintegration requires experimentation and collaboration. Criminology & Public Policy, 3(2), 161‐167. Humphreys, K. & Rosenheck, R, . (1998). Treatment involvement and outcomes for four subtypes of homeless veterans. American Journal of Orthopsychiatry, 68(2), 285‐
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Date Topics Readings Assignment 294. Kidder, D., Wolitski, R., Campsmith, M., & Nakamura, G. (2007). Health status, health care use, medication use, and medication adherence among homeless and housed people living with HIV/AIDS. American Journal of Public Health, 97(12), 2238‐2245. Class 9 Mar 23/24 Complex Policy Issues: Families at the Intersection of Multiple Systems • TANF & Health/MH Issues • Child Welfare & Health/MH Issues Special topics: Family Violence Option SOWO 830 Spring 09 Required: Blank, R. (2007). Improving the safety net for single mothers who face serious barriers to work. Future of Children, 17(2), 183‐197. Blome, W., & Steib, S. (2004, July). Like musical chairs? Become a child welfare worker. Child Welfare, 83(4), 381‐384. Substance Abuse & Mental Health Services Administration (2001). Selections from Critical Issues for Parents with Mental Illness & their Families: Executive summary: http://mentalhealth.samhsa.gov/publications/allpubs/KEN‐01‐
0109/execsumm.asp Policies impacting parents with mental illness: http://mentalhealth.samhsa.gov/publications/allpubs/KEN‐01‐0109/ch5.asp In addition, choose one: Berrick, J., Choi, Y., D'Andrade, A., & Frame, L. (2008, May). Reasonable efforts? Implementation of the reunification bypass provision of ASFA. Child Welfare, 87(3), 163‐182. Lindhorst, T., & Padgett, J. (2005). Disjunctures for women and frontline workers: Implementation Of the Family Violence Option. Social Service Review, 79(3), 405‐429 Optional: Blanchard, K. A., Sexton, C. C., Morgenstern, J., McVeigh, K. H., McCrady, B. S., Morgan, T. J., et al. (2005). Children of substance abusing women on federal welfare: Implications for child well‐being and TANF policy. Journal of Human Behavior in the Social Environment, 12(2), 89‐110. Brandon, P. D. (2008). Do disabilities in former TANF families hasten their returns to cash assistance? Social Science Research, 37(2), 530. Courtney, M. E., Dworsky, A., Piliavin, I., & Zinn, A. (2005). Involvement of TANF applicant Policy Analysis Worksheet # 2 16
Date Topics Readings Assignment families with child welfare services. Social Service Review, 79(1), 119‐157. Green, B., Rockhill, A., & Furrer, C. (2006). Understanding patterns of substance abuse treatment for women involved with child welfare: the influence of the Adoption And Safe Families Act. American Journal of Drug & Alcohol Abuse, 32(2), 149‐176. Loprest, P. & Martinson, K. (2008). Supporting work for low­income people with significant challenges (New Safety Net Paper 5). Washington, DC: The Urban Institute. Meara, L. (2006). Welfare reform, employment, and drug and alcohol use among low‐
income women. Harvard Review of Psychiatry, 14(4), 223‐232. Morgenstern, J., Blanchard, K., McCrady, B., McVeigh, K., Morgan, T., & Pandina, R. (2006). Effectiveness of intensive case management for substance‐dependent women receiving Temporary Assistance For Needy Families. American Journal of Public Health, 96(11), 2016‐2023. Pompa, L. (2007). The Family Violence Option In Texas: Why it is failing to aid domestic violence victims on welfare and what to do about it. Texas Journal of Women & the Law, 16(2), 241‐259. Schleiter, M. K., Statham, A., & Reinders, T. (2005). Challenges faced by women with disabilities under TANF. Journal of Women, Politics, and Policy, 27(3/4), 81‐95. Schoppelrey, S. (2005). Addressing substance abuse among TANF recipients. Journal of Human Behavior in the Social Environment, 12(2‐3), 111. Class 10 Mar 30/31 Complex Policy Issues: Consent, Rights, & Competence • Involuntary treatment for adults & minors • Consent to treatment for adults & minors • The concept of competence SOWO 830 Spring 09 Required: Rosenberg Ch. 7: Involuntary Treatment Interventions in Mental Health Elbogen, E., Swanson, J., Swartz, M., Van Dorn, R., Ferron, J., Wagner, H., et al. (2007). Effectively implementing psychiatric advance directives to promote self‐
determination of treatment among people with mental illness. Psychology, Public Policy, and Law, 13(4), 273‐288. Monahan, J., Swartz, M., & Bonnie, R. (2003). Mandated Treatment In The Community For People With Mental Disorders. Health Affairs, 22(5), 28‐38. Swartz, M. S., Swanson, J. W., Wagner, H., Hannon, M. J., Burns, B. J., & Shumway, M. 17
Date Topics Readings Assignment (2003). Assessment of four stakeholder groups' preferences concerning outpatient commitment for persons with schizophrenia. American Journal of Psychiatry, 160(6), 1139‐1146. In addition, choose one of the following: Korczyn, A. (2007). Drug trials in dementia: challenging ethical dilemmas. Current Alzheimer Research, 4(4), 468‐472. Kuther, T. (2003). Medical decision‐making and minors: Issues of consent and assent. Adolescence, 38(150), 343‐358. Optional: Durcan, J., & Appell, A. (2001). Minor birth mothers and consent to adoption: An anomaly in youth law. Adoption Quarterly, 5(1), 69‐79. Hollander, D. (1998). Letting minors consent to HIV tests. Family Planning Perspectives, 30(1), 2‐8. Meehan, T., Hansen, H., & Klein, W. (1997). The impact of parental consent on the HIV testing of minors. American Journal of Public Health, 87(8), 1338‐1341. Srebnik, D. (2005, June). Issues in applying advance directives to psychiatric care in the United States. Australasian Journal on Ageing, 24(0 suppl.), S42‐S45. Class 11 Apr 6/7 Complex Policy Issues: Criminal Justice & Health/Mental Health Issues • Jail diversion (drug court, mental health court) • Sentencing, treatment, monitoring SOWO 830 Spring 09 Required: Grudzinskas Jr., A., Clayfield, J., Roy‐Bujnowski, K., Fisher, W., & Richardson, M. (2005). Integrating the criminal justice system into mental health service delivery: the Worcester diversion experience. Behavioral Sciences & the Law, 23(2), 277‐293 Lamb, H., Weinberger, L. E., & Gross, B. H. (1999). Community treatment of severely mentally ill offenders under the jurisdiction of the criminal justice system: A review. Psychiatric Services, 50(7), 907‐913. Steadman, H., & Naples, M. (2005). Assessing the effectiveness of jail diversion programs for persons with serious mental illness and co‐occurring substance use disorders. Behavioral Sciences & the Law, 23(2), 163‐170. Policy Analysis Worksheet # 3 18
Date Topics Readings Assignment Class 12 Apr 13/14 Policy Team Presentations for Monday & Tuesday Classes Presentation materials Class 13 Apr 20/21 Policy Team Presentations for Monday & Tuesday Classes Class 14 Apr 27 Policy Team Presentations for Monday Class members No Class May 1 Peer Review due by 5pm SOWO 830 Spring 09 19