Provider Tools: Clinical Issues

Practice Parameters

The Los Angeles County Department of Mental Health (DMH) provides these practice parameters to assist mental health professionals in their clinical practice. Please read our General Guidelines for Using DMH Practice Parameters.

Assessment

• 2.1 Assessment & Management of Clients at Risk for Suicide 


• 2.2 Initial Psychiatric Assessment of Older Adults In Emergency Rooms & Inpatient Units


• 2.3 Psychiatric Services Provided in Emergency Medical Settings 


• 2.4 The Use of Telepsychiatry 


• 2.5 Assessment & Management of Clients at Risk for Danger to Others 


• 2.6 Discharge Planning For Older Adults 


• Initial Assessment Form for Clients Age Birth to 5 Years

Difficult Requests

• Responding to Difficult Requests from Clients/Constituents

Hospital & Attending Staff LPS Designation

• DMH Letter on Designation Guidelines 07-07 


• LPS Designation 4th Edition 7-07 letter-summary


• LPS Designation Guidelines 10-07


• LPS Privileging Guidelines


• Current Procedures for LPS Testimony in Court 95

Medications

• DMH Policy 103.1 Standards for Prescribing and Managing Medications


• 3.1 Introduction to the Use of Psychoactive Medications 


• 3.2 Use of Antidepressant Medications


• 3.3 Use of Antipsychotic Medications


• 3.4 Use of Anxiolytic Medications


• 3.5 Use of Mood-Stabilizing Medications 


• 3.6 Use of Psychoactive Medications in Co-Occurring Disorders


• 3.7 Health-Related Monitoring & Interventions in Adults

Programming

• 4.1 DMH Outpatient Clinic Environment 


• 4.2 DMH Outpatient Programs with Staff Authorized to Initiate Involuntary Detention 


• 4.3 Treatment of Non-Compliance in Outpatient Clinical Settings 


• 4.4 The Use Of Psychosocial Rehabilitation Interventions 


• 4.5 Clinical Treatment of Individuals with Co-Occurring Substance Abuse


• 4.6 Psychiatric Treatment of Patients in IMDs


• 4.7 Clinical Supervision in DMH Outpatient Programs


• 4.8 Delivery of Culturally Competent Clinical Services


• 4.9 Referral to Self-Help Groups


• 4.10 Parameters for Wellness Centers


• 4.12 Parameters for Service Relationships in a Recovery-Based Mental Health System


• 4.13 Parameters for Department of Mental Health Peer Advocates

Psychotherapy

• 5.1 The Use of Psychodynamic Psychotherapy


• 5.2 The Use of Cognitive-Behavioral Therapy


• 5.3 The Use of Interpersonal Psychotherapy


• 5.4 The Use of Supportive Psychotherapy


• 5.5 The Use of Psychotherapy with Children, Adolescents, and their Families


• 5.6 The Use of Family Therapy Techniques with Families of Adult Children

General Guidelines for the Use of DMH Practice Parameters

• DMH parameters represent critical factors to be considered in the provision of care in DMH and are not comprehensive treatment guidelines. An in-depth knowledge of the clinical skills essential for the provision of quality mental health services to consumers should result from ongoing clinical training and regular review of relevant literature.


• These parameters represent the consensus among DMH clinicians and experts.


• These parameters apply regardless of the funding source for the treatment: Medi-Cal, County General Funds, or other.


• These parameters in no way substitute for the consumer/clinician dialogue and respect for consumers that is at the core of sound clinical practice.


• These parameters are not absolute, but practice outside of such parameters requires special justification, documentation, and in some instances consultation.


• These parameters are designed to encourage consultation, monitoring, and supervision at clinical sites rather than at more remote administrative locations, and to encourage education and training.


• The specialized technical and interpersonal skills required mandate specific education and supervision for all practitioners.


• Changes in current regimens made for the purpose of conformity with these parameters should be initiated only after careful consideration of the original reasons for the current treatment.


• These parameters reflect current interpretations of best practices, and may change as new information and techniques become available.


• Special efforts must be undertaken to respect the unique values, spiritual beliefs, lifestyles, cultural and personal experiences, anxieties, and need for autonomy that are at the core of working with all consumers.