But these have and it was enlightening to hear Dr. David Hnatow describe the development of the Crisis Care Center during a workshop at this week's first International Crisis Intervention Team Conference.
Hnatow is chairman of the Community Medical Directors' Roundtable.
The group tackled the county's system of delivering care for the acutely mentally ill at the behest of city and county officials concerned over the criminalization of the mentally ill and the inefficient use of law enforcement.
The goal for the panel was simple: treating the severely mentally ill rather than just throwing them in jail.
But getting there would be a hurdle over egos, turf and understanding.
"Each of them has their own little silo ... trying to provide their own little niche of care," Hnatow
The group's name soon became a misnomer.
Medical directors were first called to the table because so many emergency rooms were overflowing with patients needing psychiatric services. (It's also where the system's fragmentation was obvious because ERs had different approaches to assessment and treatment of severe mental illness, Hnatow said.) But they quickly were joined by representatives from law enforcement, community and mental-health advocacy organizations, and even judges and others from the political realm.
Hnatow, who was medical director for the University Hospital Emergency Center at the time, said he didn't send out invitations.
Participation grew by word of mouth, with as many as 90 people attending the panel's monthly meeting at its peak.
"In retrospect," he
told me after his
presentation Tuesday, "I think the problem was so bad, people wanted a fix."