Toward public value?

Selected articles from a conference organised by the Department of Management at Monash University in November 2003 entitled ‘Toward Public Value? Management and Employement for Outcomes’.     

Developmental trends in adolescents' psychological and legal competence to consent to abortion

United States Supreme Court has affirmed the right of states to require parental consent or notice from minors seeking abortion. We examine an underlying presumption that minors are not competent to consent to abortion. Participants (N=75 age 13–21, seeking a pregnancy test at a women's medical clinic) completed an interview that was audiotaped and scored on four cognitive and volitional criteria of legal competence. Competence was compared in three age groups (≤15; 16–17; 18–21) for participants who considered abortion and for those who did not. Adolescents age 16–17 and adolescents ≤15, who considered abortion, appeared as competent as legal adults; only≤15-year-old adolescents who did not consider abortion appeared less competent. Regression analysis was used to identify psychosocial predictors of competence. Results challenge the presumption that minors are not competent. An alternate policy based upon informed consent and empowerment of minors as decision makers is proposed.     

The relocation of released mental hospital patients into residential communities

The mental health patient release programs have been proceeding more rapidly than informed judgment could possibly warrant. Public sector mental health care, whether centralized in state hospitals or deconcentrated within residential communities, falls considerably below the standards and practices of private sector care. The accelerated release of former patients has strained the potential for therapeutic community placement. The massive reassignment of patients has been prompted by the goals of: providing for the civic and therapeutic rights of patients; providing knowledgeable and effective treatment; implementing cost savings; and integrating in-patients within a more aware and accepting inclusive society. The structural elements of the assignment process can be examined within the context of a reassignment model in order to identify the informational and program needs for a reasonable release and aftercare process. The present reliance upon salvage of the poorly conceived release programs through ghettoization of ex-patients can only be justified as a mechanism for forcing a wide range of communities to accept long overdue responsibility for their disabled members.Professor of Geography and Urban Planning, Princeton University. Grateful acknowledgement is made to the NIMH (METRO Division) for research support to the Regional Science Research Institute (Philadelphia, Pa.), to the Center for Advanced Study in the Behavioral Sciences for fellowship support during the period this study was undertaken, and to Maurice Rappaport (Agnews State Hospital, Calif.), Harold Baker (Aftercare Services Division, Calif. Dept. of Health), Anthony Mumphrey, Daniel Garr (San Jose State University) and Montye Rivera (Home Care News, San Jose, Calif.) for their assistance in the conduct of this research.