01/26/2012 12:28 pm ET Updated Mar 27, 2012

The Landscape of Mental Health: An Interview With D.C. Mental Health Director Stephen Baron

By Ted Henson
Street Sense Volunteer

Ted Henson, co-founder of Street Sense talks with Stephen Baron, the mental health director for the District of Columbia.

Henson: The origins of the “Dixon Case” go back to 1974, when a class action lawsuit was filed against the federal government and District government on behalf of individuals civilly-committed to Saint Elizabeths Hospital in Southeast D.C. The plaintiffs demanded community-based treatment alternatives to hospitalization for mental illness. The lawsuit was part of a much larger deinstitutionalization movement that swept the nation, driven by a growing awareness of patient’s rights and the development of anti-psychotic drugs. Deinstitutionalized patients were supposed to receive ongoing community-based support and care, but instead, many languished and some ended up homeless. The settlement of the Dixon case includes an emphasis upon community-based care and housing for former mental patients. Under the terms of the Dixon settlement, the District’s Department of Mental Health (DMH) was required to meet 19 exit criteria. A recent court ruling has stated that the DMH has met 15 of these 19 criteria but still needs to make progress on the four outstanding criteria.

When the lawsuit was filed in 1974, there were nearly 3,600 patients at St. Elizabeths. As a result of deinstitutionalization and a shift in policy by the Department of Mental Health to provide the primary treatment of individuals at community-based mental health providers, the current number of patients at St. Elizabeths has decreased dramatically. There are currently around 270 patients at the hospital.

Henson: In reference to the Dixon criteria, you recently said that the settlement agreement is "a recognition of tremendous progress...not a recognition of a job completed." Can you give our readers a brief overview of the progress you have made regarding meeting the 19 exit criteria and what’s left to be done?

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