New Study Examines Effects of Stopping Psychiatric Medication UCLA Luskin School professor co-authors report showing that more than half succeed in discontinuing usage of drugs

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Despite numerous obstacles and severe withdrawal effects, long-term users of psychiatric drugs can stop taking them if they choose, and mental health care professionals could be more helpful to such individuals, according to a new study.

A new study shows that while long-term users of psychiatric drugs can stop taking them if they choose, mental health care professionals could be more helpful to such individuals dealing with problems like severe withdrawal effects.

While 1 in 6 Americans take a psychiatric medication for serious mental illness, there is little research on people’s experiences coming off the drugs. In the first large-scale study in the United States on this subject, Live & Learn, Inc., in partnership with researchers at the UCLA Luskin School of Public Affairs, UC San Francisco and New York University, began to fill this knowledge gap. Study findings are now available online in Psychiatric Services, a journal published by the American Psychiatric Association.

Surveying 250 long-term users of psychiatric medications who had a diagnosis of serious mental illness and chose to discontinue use, the study found that more than half succeeded in discontinuing usage, despite having little professional support while experiencing severe withdrawal symptoms including insomnia, crying and diarrhea. The majority of survey respondents cited the main reason they attempted to quit centered on health risks of long-term use and side effects.

Of the study’s respondents, 54 percent managed to stay off psychiatric medication for at least one year, with few reporting relapse or re-hospitalization. Eighty-two percent of those who discontinued use reported being “satisfied” with their choice.

“People stop taking their psychiatric medications whether or not they find the drugs helpful, and they do so at all stages of the medication experience — days, weeks, months, or years after taking them,” said David Cohen, professor in Social Welfare at UCLA Luskin and a co-author of the study.  “This study is novel because it asks questions about stopping to take medications from the consumer’s point of view.”

Many industry-funded studies have asked patients why they stop taking their medications, but typically with a view to increase compliance, according to Cohen. By contrast, this study asks consumers what they experienced while coming off drugs, who helped them make and carry out their decision, and whether they were satisfied with their attempted or completed discontinuation.

“Over 70 percent of our study sample had taken medication for more than a decade; however, these individuals reported having little to rely on when discontinuing except the internet and social support in order to endure withdrawal. Limiting access to care through cuts to health and psychosocial services can only make that situation worse,” says principal investigator Laysha Ostrow, founder and CEO of Live & Learn, a California-based social enterprise that provides research, technical assistance and knowledge translation services to behavioral health systems. “Most were working with a provider at the time but did not find them helpful in the process. However, even though it was often complicated and difficult, the majority who were able to come off medication completely were satisfied with their decision to do so.”

Cohen said that there are still plenty of challenges for researchers who are examining this topic.

“There’s a lot of work to do to understand how people come off medications and how to help them do so safely, especially when they’re taking several psychiatric medications simultaneously,” he said. “This study didn’t use a probability sample. Though it very carefully selected the 250 respondents, most with over 10 years’ history of taking medications, it should be a priority to confirm or modify these findings with a probability sample.”

The study was funded through a grant by the Foundation for Excellence in Mental Health Care.

Dispensing Knowledge in Real Time UCLA Luskin Social Welfare students present the results of their rapid response research projects

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By Stan Paul

Research, by design, is focused, systematic, methodical. It takes time.

But when information moves at the speed of social media, and false, distracting and potentially harmful information can be spread worldwide via tapping a screen in the middle of the night, there is a pressing need for responsible research that can be produced in real time.

A dozen social welfare graduate students at the UCLA Luskin School of Public Affairs reacted to this challenge by taking on projects — above and beyond their required studies — to match their data-gathering and synthesizing skills with the ability to make useful information available quickly to communities that may need it.

The social welfare master’s and doctoral students researched topics such as hate speech and immigration.

“You are going to enter your profession, a profession built around the question of human caring, at a time where human caring is not held in particularly high esteem,” UCLA Luskin Dean Gary Segura said in introducing “Rapid Response Research in the Trump Era,” a June 1, 2017, gathering at the Luskin School to review student projects.

Segura, whose research has centered on representation and empowerment, said: “You know the challenges that all of us face … across all racial and ethnic, socioeconomic subpopulations in the United States: access to affordable health care, dealing realistically and honestly with challenges that individuals and families face, providing quality education and job opportunities for people. The list is unbelievably long.

Social Welfare student researchers, from left, Evelyn Larios, Zee Graef, Skye Allmang, Sandra Delgado, Jackie Diaz with Laura Wray-Lake, assistant professor of social welfare, at the rapid research presentation. Photo by Stan Paul

“The first piece of advice I’m going to give you for resistance is to call things by their name,” Segura said. “We must begin our resistance by calling things what they are: Racism is racism, sexism is sexism, anti-Semitism and Islamophobia are what they are.” He urged students not to pass these things off as merely rants not worthy of comment or notice.

Laura Abrams, the incoming chair of UCLA Luskin Social Welfare, said that a list of potential research ideas was presented to social welfare students early in the academic year, and a number of groups responded. The criteria for the projects included working with real-time data from social media platforms such as Twitter.

Abrams said the research topics “were going to be more immediately applicable to what communities might need in order to resist and they had to be social justice oriented.” Social welfare faculty such as assistant professors Ian Holloway and Laura Wray-Lake served as advisers for the students.

One project examined Twitter data based on the motivations of those who participated in the Women’s March, and how that motivation connects — or doesn’t — with broader issues of racial justice.

One immigration issue tackled by the students was part of a nationwide project asking how young people have been affected by the policies and rhetoric of the Trump administration. That project relied on responses from Latino high school students. The information gathered is intended to inform educators and others working with adolescents.

First-year MSW student Alexandra Rhodes said she studied anti-LGBT hate speech and the incidence of particular words used on Twitter.

“I was interested in seeing if anti-LGBT hate speech on Twitter increased after Donald Trump’s election,” said Rhodes, who gathered information from more than 40,000 users who had tweeted anti-LGBT search terms. From that group, just over 10,000 users were randomly selected for comparison of the number of such tweets before and after the election.

“I was most interested in how Donald Trump’s election was affecting the LGBT population given his seemingly anti-LGBT rhetoric and policies,” said Rhodes, who is primarily interested in working with the LGBT population and is considering pursing a Ph.D. in social welfare.

“It is very important to me to do ethical and essential research in my community and build evidence to support how we have been affected by various social changes and policies,” Rhodes said. “For now, I’m focusing on getting involved with research in whatever way I can as an MSW student. It is important to do research and look at the data and respond to what is happening right now.”

Abrams said she hopes that this becomes a tradition that can continue to be built into the curriculum in a meaningful way.

“As a Social Welfare Department, the rapid response research projects are a prime example of what we can accomplish when we have an idea, put our heads together, and work hard as team,” Abrams said. “I am proud of the students for carrying out their projects in such a timely and rigorous manner.”

Public Policy Professor Is Honored by UCLA Randall Akee receives C. Doris and Toshio Hoshide Distinguished Teaching Prize in Asian American Studies

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By Asian American Studies Center Staff

Assistant Professor Randall Akee of the Department of Public Policy and American Indian Studies is the 2016-17 recipient of the C. Doris and Toshio Hoshide Distinguished Teaching Prize in Asian American Studies at UCLA.

Akee is emerging as one of the most important and influential scholars studying the socioeconomic conditions of indigenous people and formulating strategies to address their marginalization. He is a former economic development specialist for the state of Hawaii, Office of Hawaiian Affairs. Since 2013, he has served on the U.S. Census Bureau’s National Advisory Committee on Racial, Ethnic and Other Populations. Akee has conducted extensive research on several American Indian reservations, Canadian First Nations, and Pacific Island nations in addition to working in various Native Hawaiian communities. His main research interests are labor economics, economic development and migration.

Colleagues and students expressed that Akee is deserving of the Hoshide Award honor. He has taught key courses that benefit Asian American Studies, incorporating Pacific Islanders, an understudied racial group in the United States. One colleague stated, “He epitomizes a faculty who bridges disciplinary silos — American Indian Studies, Asian American Studies and Public Policy — not an easy task at UCLA.”

In his “Economic Principles and Economic Development in Indigenous Communities” course, Akee uses Micronesian migration to Guam and the U.S. and Tongan migration to New Zealand as examples of diaspora of indigenous peoples. The significant international movement of Pacific Islanders makes this group unique among indigenous populations, creating challenges to how students understand the indigenous experience. It is the only course offered at UCLA focusing on the prosperity of indigenous nations and communities globally through economic subsistence.

“I learned first-hand of the high expectations he has for his students. Dr. Akee challenges his students intellectually. As one of a few Pacific Islander students, it made me think about what it meant to be a Pacific Islander scholar,” said one student.

Another student noted, “With the purpose of using data to show how Native people have successfully approached economic development, Dr. Akee effectively engaged our class in a way that felt both very thorough and intimate.”

Akee’s “Pacific Island Economic Development” course focuses on the Anglophone former colonies and countries in the Pacific. The class examines the economic and political development of the Hawaiian Islands, Fiji, the islands of Micronesia, Samoa and Tahiti.

A student commented, “I enjoyed every minute of Dr. Akee’s class because it challenged me to look beyond the scope of my field and bridge western-indigenous methodologies to critique economically sustainable programs in the South Pacific.”

Akee also worked with Pacific Islander graduate students to establish the Graduate Student Association for Pasifika. It was created to support graduate students from Native Hawaiian and Pacific Islander descent or areas.

As one student expressed, “Dr. Akee is a role model, but a mentor to countless Pacific Islander students. He offers unencumbered and relentless support to any student seeking his guidance, which, I believe, reflects his love for teaching, research, but more so his community.”

The late C. Doris Hoshide, class of 1934, of Rockville, Maryland, established the teaching prize to annually recognize an outstanding professor in Asian American Studies. She was a longtime supporter of Asian American Studies at her alma mater. The Hoshide Prize includes a $1000 award.

Akee received his Ph.D. from Harvard University in political economy, his M.A. from Yale University in international and development economics, and his bachelor’s degree from Dartmouth College in economics. The award was announced by the Asian American Studies Center’s Interim Director Marjorie Kagawa Singer and Assistant Director Melany De La Cruz-Viesca.

More Than 45,000 Californians Living With HIV Would Be Impacted by Medicaid Cuts in Senate Health Plan According to a fact sheet from the California HIV/AIDS Policy Research Centers, the cuts would be felt by patients covered by Medi-Cal

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Tens of thousands of Californians living with HIV would be impacted by Medicaid cuts under the Better Care Reconciliation Act (BCRA), according to a fact sheet released by the California HIV/AIDS Policy Research Centers in collaboration with the UCLA Luskin School of Public Affairs.

The fact sheet highlights new data from the California Department of Public Health, Office of AIDS, which indicates that 45,033 people living with HIV received health coverage through Medi-Cal in 2014. These data also indicate that approximately 11,500 people living with HIV enrolled in Medi-Cal because of the Affordable Care Act (ACA). Medi-Cal, California’s Medicaid program, covers the cost of medications that help low-income people living with HIV achieve viral suppression, which both improves their health and prevents new infections.

Last week, the U.S. Senate released the BCRA, which would make dramatic cuts to Medicaid. A similar bill passed by the U.S. House of Representatives, the American Health Care Act (AHCA), would have cut Medicaid nationwide by $834 billion over 10 years.

View resources and an FAQ from testing.com about at-home STD testing

The BCRA would radically restructure the Medicaid program by converting it to a per capita cap or block grant and effectively end the ACA’s Medicaid expansion. Together, these changes would result in a massive fiscal shift from the federal government to the states and add billions in additional costs to the state of California.

“People living with HIV have complex health-care needs that require high-quality, consistent and affordable health care,” said Ian Holloway, director of the Southern California HIV/AIDS Policy Research Center and an assistant professor in the Department of Social Welfare at the UCLA Luskin School of Public Affairs.

The CHPRC fact sheet emphasizes that limits on Medicaid financing and coverage would have a detrimental impact on California’s efforts to provide care and treatment for people living with HIV and to reduce new HIV infections.

“It is important for policymakers to understand the threats the BCRA poses to people living with HIV and other vulnerable communities in California,” Holloway said.

 

Giving Microeconomics a Human Face Public Policy professor Manisha Shah’s research bridges a worldwide gap between health, economics and education

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By Stan Paul

At age 16, Manisha Shah went to the Andes Mountains of Ecuador — her first chance to dig into “real development work.” The task after a year of fundraising and training? Building latrines in rural communities. Soon after arrival, however, she realized that everyone there “already knew how” to build latrines.

What they actually needed was financing and supplies. “That is what we helped facilitate — paying for and transporting supplies to this faraway town in the middle of the mountains.”

The experience in Ecuador was transformative for Shah, now an associate professor of public policy at UCLA Luskin. It enhanced a developing global view nurtured as a child during family visits to see her grandparents in India, where she saw “poverty all around her.”

Her youthful travels helped put Shah on the path to her career in academia and research around the world — from Mexico to India, Tanzania to Indonesia — and eventually to the Luskin School of Public Affairs.

“Never in a million years would I have predicted that I would be a tenured professor at UCLA,” Shah said. “I feel so lucky to be doing what I love at one of the best universities in the world.”

Getting There

Today, Shah focuses her teaching and research on the intersection of applied microeconomics, health and development. She is supported by organizations that include the Bill and Melinda Gates Foundation, the William and Flora Hewlett Foundation, and the World Bank.

Scholar Manisha Shah clarifies a point for students during a lecture in the Public Affairs Building. Photo by George Foulsham

An example of her work is a recent study, “Investing in Human Capital Production: Evidence from India,” that fills a substantial gap in development literature related to whether early-life investments encourage more educational investments later on, whether low-skill wages in rural India increase school dropouts, and whether rural schools produce gains in consumption later in life. The results have widespread implications for family and individual well-being, economic growth and national competitiveness for the country of over a billion people.

Her research affiliations and teaching might suggest otherwise, but Shah’s path was not exactly a straight one. “I don’t think I had a direct route. In fact, it was very indirect,” said Shah, who sought work abroad after earning undergraduate degrees in economics and development
at Berkeley.

“I quickly learned how difficult it is to find a job that will actually pay you to do international work,” she said.

She wound up in a one-year program at the London School of Economics where her master’s thesis in development economics examined HIV/AIDS issues in India and how NGOs were working to fill gaps in countries that were slow to react to potential epidemics.

“This was 1996-97. Getting HIV in a developing country was a death sentence, and so many countries were doing little to publicly acknowledge they even had an HIV problem,” Shah said.

Next was Mexico, and work at the International Maize and Wheat Improvement Center. Shah is fluent in Spanish, and at the time thought she was “done with school and would never come back,” having achieved her goal of working in international development. “I loved the job.”

But there was a catch.

“I knew I wanted to keep doing this type of work, but I also started to realize that the people calling the shots, raising the money, directing things, all had Ph.D.s,” Shah said. So she spent a year doing the math — literally, taking the calculus, statistics and real analysis coursework she needed for a doctoral program at UC Berkeley. “There was almost no literature in economics on HIV/AIDS,” Shah said of her ongoing interest in the intersection of HIV and economics. “I learned that most interventions in development related to HIV/AIDS often targeted sex workers, as they tend to have higher rates of sexually transmitted infections and HIV/AIDS than the general adult population in most developing countries.”

Shah’s eyes were opened when she learned how many women in developing countries are employed in the sex sector. She saw the implications for public health and noted a lack of serious empirical study, which “began an important area of research for me.”

She recently co-edited the “Oxford Handbook of the Economics of Prostitution,” in which more than 40 researchers from around the world compiled and interpreted valuable economic data and research that may help lawmakers and government officials set policy guidelines concerning prostitution worldwide.

“A number of factors, including the proliferation of sexually transmitted infections and HIV/AIDS, especially in developing nations, have created the need to look at prostitution through an economic lens,” she said.

And yes, like the teenager who traveled to Ecuador decades ago, Shah is still interested in sanitation, a core issue at the intersection of human health and economics
in developing countries.

Research and Public Policy

Shah refers to herself as an applied microeconomist interested in development economics, health and education. “Most of my research fits into those bins,” Shah said.

She has written papers on the long-term impacts of positive rainfall shocks as well as drought in India on human capital outcomes of young children and adolescents, and risk-taking behaviors in the wake of natural disasters, as well as the effects of cash transfer programs on criminal behavior in Indonesia. Behind each are human stories of how policies affect large populations.

Shah’s research on HIV and the sex industry has wide-ranging implications for the health and well-being of not only adults but also vulnerable young people caught up in prostitution around the world.

“These days most of my work is either related to children or adolescents,” Shah said. “I often joke that my switch to research about children perfectly coincides with my becoming a mother. I remember researching questions about child development when I was pregnant and being surprised about how little we know about many important issues related to child cognitive/health and development.”

Shah is the principal investigator of a randomized controlled trial in Tanzania attempting to understand how to improve sexual and reproductive health outcomes for teenage girls. “I am really excited about this work,” said Shah, who was also recently awarded a National Science Foundation grant to better understand education outcomes for children in rural India.

After teaching stints at the University of Melbourne, Princeton University and UC Irvine, she joined the Luskin faculty in 2013. Today, she teaches microeconomics, development economics and serves as a faculty adviser for the Applied Policy Project (APP), a challenging yearlong requirement for master of public policy students at Luskin.

“Ironically, I learned in grad school that I actually enjoy teaching, and I was sort of good at it,” she said of her classroom duties. Her research topics are heavy, which could lead to frustration about things that should be happening but don’t. “But spend some time with our students and it will put you in a good mood,” she said.

“Our students make me optimistic, and that optimism can be infectious. I love how our students care so deeply about issues that matter to them.”

 

A Final Test for Policy Analysis Projects UCLA Luskin public policy master’s degree culminates in a public forum in which students present Applied Policy Projects on issues of regional, global importance

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By Stan Paul

By necessity, the Master of Public Policy (MPP) students at the UCLA Luskin School of Public Affairs quickly begin learning skills and tools to complete the program and prepare for problem-solving careers in the public, private and nonprofit sectors.

The students, working in groups, must clear one final hurdle to graduate: the Applied Policy Project presentation.  Each group has 20 minutes to impress faculty and peers by showcasing what they have learned during two rigorous years of study.

Each year, a diverse group of clients “hire” the students, usually in teams of two or more, to tackle real-world problems and offer actionable recommendations and feasible solutions.

“I think one of the exciting aspects of the APP is the variety of topics covered,” said Manisha Shah, associate professor of public policy and faculty coordinator of the program. “Because our students have a diverse set of interests and because we encourage them to identify their own clients, the result is an interesting variety of APP projects.”

Carlos Meza, Elizabeth Canales and Samuel Fox discuss how to improve juvenile diversion in Los Angeles. Not pictured is Jasmin Reyes-Moncada. Photo by Les Dunseith

Among this year’s clients were the Southern California Association of Governments, Covered California, Peterson Institute for International Economics and a member of the California State Assembly. Internal clients included a research center within the Luskin School, a professional program elsewhere on campus and the University of California’s Office of the President.

“The first-year curriculum of the MPP program is tool-driven,” Shah said. “What I mean by that is we try to give students a diverse set of tools — both quantitative and qualitative — that will help guide them through the APP process and ultimately go out into the real world and conduct policy analysis on issues close to their hearts.”

Shah said she was fortunate to advise a diverse set of APP groups this year. One group of students found that behavioral tools such as reciprocity and commitment devices should be implemented in schools to increase consumption of fruits and vegetables in an attempt to combat obesity. Another group helped improve the service delivery model of an organization in L.A. that tries to get at-risk youth into better employment opportunities. And another group proposed interventions and policies aimed at reducing displacement and gentrification in South L.A.

In all, 18 presentations were made. Luskin faculty watched and then asked questions that tested the students’ depth and breadth of knowledge and the thoroughness of their projects.

The range of projects is broad, including:

  • Local and regional issues such as investments in electric vehicle charging stations in Los Angeles and a rent stabilization ordinance to prevent displacement of low-income minority communities in South Los Angeles.
  • Statewide issues such as bail reform, insuring Californians, health care, access to water and juvenile justice.
  • National and global issues like mitigating the negative impacts of trade on employment in the U.S. auto industry and improving local-level governance amid decentralization reforms in the Ukraine.

A closer look at some of this year’s APPs follows.

Gender Issues in Engineering

Applying qualitative and quantitative methods to their study for the UC’s Office of the President, Traci Kawaguchi, Yuhan Sun and Eri Suzuki focused on the need for connections in their analysis of system-wide retention by gender in engineering at the undergraduate level. They initially determined that the retention rate of female engineering students was significantly lower than for male engineering classmates across the UC system.

Their faculty adviser, Professor of Public Policy John Villasenor, also holds an appointment in electrical engineering at UCLA. He helped connect them with UCLA engineering students, which led to interviews with aspiring female engineers.

Women and men had similar levels of academic performance in the first year, but the qualitative interview uncovered that “affinity groups play a key role in affirming engineering identity and belonging in the field,” according to the UCLA Luskin students’ written summary.

“I think the big thing that came up was just the idea of fitting in,” Kawaguchi said. “When you go into a classroom that is 80 percent male … it may make you feel that you don’t necessarily belong.”

Team members analyzed policy options based on anticipated effectiveness, cost feasibility and institutional feasibility, and they recommended support for female students based on a sense of community and belonging. Adoption of residential living communities and formal peer mentoring programs for female undergraduate students in engineering were also recommended.

 A Program to Help Plug-In Commuters

Another APP team focused on plug-in vehicles with a limited range on all-electric power that switch to gasoline-based power after batteries are exhausted. Specifically, the group studied how workplace charging stations in Los Angeles could increase the number of miles that vehicles travel without burning gasoline.

MPP students James Di Filippo, Mahito Moriyama, Toru Terai, Kelly Trumbull and Jiahui Zhang completed their project, “Prioritizing Electric Vehicle Charging Station Investments in Los Angeles County,” for the Southern California Association of Governments (SCAG). Their model combined commuting data from SCAG’s transportation demand study with plug-in electric vehicle registration data, information on vehicle all-electric range, and point data on existing charging infrastructure locations.

The students found that nearly 6,000 plug-in hybrid commuters could benefit from workplace charging but currently do not have access. Full support of those commuters’ vehicles would yield about 76,000 additional miles driven on electric power each day.

The potential increase is concentrated in just a few zones. Di Filippo said that the group used a tool from the Environmental Protection Agency to identify zones that fall within disadvantaged communities that might require additional support, which were more than a third of all zones identified as having potential for investment across Los Angeles County. SCAG should direct additional funding toward those disadvantaged communities to ensure that the benefits are distributed equitably, the students said.

Di Filippo said that the APP process was challenging but rewarding. “I credit my teammates for pulling together quickly, conceptualizing and delivering a strong report that offers actionable information for SCAG’s electric vehicle charging infrastructure siting decisions in only eight weeks,” he said. “My team was fortunate to have the support of faculty and peers who were invaluable in shaping our thinking on key aspects of the report.”

Healthy Food for Children

Sarah White and teammates Sydney Ganon, Hiroto Iwaoka and Jonathan McIlroy examined behavioral economics for tools in nutrition education curricula. Their goal was to promote long-term healthy food choices and habits in third and fourth grade students in light of a growing recognition of negative health outcomes of childhood obesity.

“While the field of behavioral economics is still fairly new, we read a lot of the existing literature and had reason to believe that really low-cost interventions could potentially have large impacts on getting people to make better choices for themselves,” White said.

One challenge that behavioral economics has “rarely, if at all, studied within the realm of children’s nutrition.” That made evaluating different policy options more difficult. “We had to evaluate each policy option on our own,” White said.

The group’s recommendations bundled three potential behavioral tools that are cost-effective. Giving attractive names such as “power peas” to fruits and vegetables in the cafeteria would frame foods in a way that is appealing to children. Giving students something as simple as a sticker and thanking them for choosing the healthy option would promote reciprocity. Having students set goals for eating better would make them more likely to stay committed.

Ayappa Biddanda

Rocking his Comeback

For one student, Ayappa Biddanda, the final APP presentation was a long time in the making. In the early 2000s he left UCLA Luskin to pursue an opportunity that turned into a career in the music industry. He came back this year to do his final presentation — and thus finish his master’s degree.

Biddanda’s project evaluated the impact of an educational enrichment program called Rock the Classroom that paired local musicians with students in the Los Angeles Unified School District. Biddanda’s solo presentation on the final night of the APP program literally rocked the classroom with musical sound bites and his enthusiastic, informative and professionally presented argument that, in education, “art matters.”

A Fond Farewell

Wrapping up two decades of APP presentations, Mark Peterson, chair of the department, thanked the students for their efforts. “I really want you all to applaud yourselves,” he said. “The hard work that went into all of the presentations was obvious to us all, and we really just admire the time you put into all of this and the work that you did to put these presentations on a scale of professionalism that we like to see.”

The 2017 APPs ended on a bittersweet note, with Peterson acknowledging the retirement of a key player. Maciek Kolodziejczak is a longtime UCLA staff member who joined the public policy program when it was founded more than 20 years ago and has long coordinated the APP presentations.

“Sadly, this is the last time that this part of the APP program will be orchestrated, moderated and run by Maciek,” Peterson said.

From the UCLA Luskin Flickr feed:

2017 Applied Policy Project presentations

Can L.A. Fix its Broken Planning System? UCLA Luskin urban planners discuss the challenges — and possible solutions — to L.A.’s development woes

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By Les Dunseith

“In Los Angeles, we do have a rather broken planning system,” Michael Lens, an assistant professor of urban planning, said during an interview after the defeat of a controversial ballot initiative, Measure S, that had sought to clamp down on Los Angeles development.

Lens and other UCLA Luskin faculty members with expertise in housing density, land use and the related issues of home affordability and transportation say Measure S reflected long-simmering dissatisfaction with how vital decisions about growth, density and housing affordability are made. And they hope increased public awareness will lead to positive change in the state’s planning process.

UCLA Luskin hosted a panel discussion on Feb. 9, 2017, to discuss the pros and cons of Measure S, a ballot measure to limit local development. Photo by Les Dunseith

“L.A. has a very low-density zoning law,” explained Michael Manville MA ’03 PhD ’09, an assistant professor of urban planning at UCLA Luskin. “Its general plan is set up for the city as it was 40 years ago. The zoning never caught up with the fact that L.A. became much more urban.

“Now, as a result, in many parts of the city, to build any kind of housing that we actually need — multifamily housing — it’s illegal.”

That means that a zoning exception must be granted for large housing projects, which leads to often-protracted negotiations between developers and members of the L.A. City Council.

“There is a feeling — that is often true — that developers can get something built if they give enough money to the right council member in the right circumstance,” Lens said. “Then the developers build something big where the community never expected something big to go.”

The current process often frustrates citizens, but the benefits to select policymakers and large real estate developers get in the way of reform efforts, Manville noted.

“Developers who can afford to play the game like it,” Manville said, noting that although they must wait as long as a year to start building on land that is sitting unused during negotiations, the developers end up with the “right to build extra units in a very hot property market. And that probably means more profit.”

Associate Professor of Urban Planning Paavo Monkkonen MPP ’05 recently analyzed California’s ongoing housing crisis in a policy brief, or white paper, that provides a detailed look at why people are deeply troubled by the current process as outlined in California’s General Plan and various community plans that govern housing density decisions.

“One of the main things I learned in writing the white paper is that nobody likes new development near them,” Monkkonen said.

The result is a Catch-22 that squeezes the general public from both directions, leaving the average L.A. resident with a choice between paying high rent or seeking a risky loan to buy a home they really can’t afford.

‘A City Can Only Sprawl So Far’

A look at the population and housing numbers for Los Angeles clearly illustrates the problem, said UCLA Luskin’s Joan Ling MA UP ‘82, a longtime lecturer in urban planning who has deep experience in real estate analysis and affordable housing. She cited a study by Greg Morrow PhD ’13. “In 1960, there were 2 million people living in the City of Los Angeles, and the zoning capacity was set for 10 million people. In 2010, the city’s population was 4 million people, but the zoning capacity had been reduced to 4.3 million. So, in fact, we had enough zoning capacity for only 200,000 to 300,000 in additional growth.”

It’s a bad situation that is projected to get even worse. By 2040, Los Angeles is projected to grow by another 800,000 people.

“So where are these people going to go?” Ling asked. “That’s the real problem.”

California has enticing natural features. But most areas are unsuitable for human occupation, or the land is already used by industry or agriculture.

“A city can only sprawl so far,” Ling explained, noting that traffic in Southern California has become a daily nightmare for many people.

The NIMBY (not in my back yard) syndrome is an ever-present issue in California, Monkkonen said. When a new, higher-density project is proposed almost anywhere, neighborhoods rise up to block it. “So this is what happens when we have built horizontally to the fringes of the metropolitan area as much as commute times will allow — we get traffic jams and a lack of affordable housing,” he explained.

California’s flawed system of zoning effectively blocks housing affordability, according to several faculty members in the Department of Urban Planning. For example, Monkkonen noted that condos are much cheaper to build and thus much more affordable than single-family homes, but condos “are illegal in 75 percent of L.A. Effectively, using the power of the state, we have prevented the majority of the people in the U.S. and the majority of the people in L.A. from ever buying a home.”

The state’s love of automobiles and its idyllic notion of cul-de-sac suburbs — the California Dream itself — is part of the problem.

“People come here with a certain picture of Los Angeles,” Lens noted. “A place with yards. A place where you have the freedom to get in your car and go where you need to go.”

‘A Horrible Place to Walk or Bike’

It’s a belief system that also contributes to a popular “American idea that when you talk about density, you talk about high-rise buildings,” Manville said. “Not too many people understand that Paris is twice as dense as New York City, and Paris has no high-rise buildings. It’s just that it’s consistently four to six stories.”

Manville thinks that Los Angeles could get a lot denser, and yet remain livable, just by turning many single-story neighborhoods into two-story neighborhoods, especially along major boulevards.

“L.A. has pulled off this amazing trick, where you have a city in which large portions are relatively flat, where the weather is always nice, and it’s a horrible place to walk or bike,” Manville said.

Certainly, a denser neighborhood is going to end up with more congestion, Manville acknowledged. “But the thing that people forget is that most of their driving probably isn’t in their neighborhood. If [new housing] is not built in their neighborhood, then it’s going to be built somewhere. And they’re probably still going to encounter those cars somewhere else.”

If the density is done well, then people experience more opportunities not to be in their cars. “If the density isn’t done well, then you can get the worst of all worlds,” he said.

A denser neighborhood, if it’s designed carefully, becomes a more pleasant place to walk and live. Manville points to London, which embraced the idea that to manage its congestion, it needed to charge people to drive.

“If you actually do something that makes congestion better — which is what charging does and nothing else does — then you can knock down a lot of the concerns about more density. And a lot more good things can flow from that,” Manville said.

The congestion toll in London has added housing and allowed transportation authorities to “take back a lot of the space that had previously been allocated to cars,” Manville said. “There are just so many more sidewalks and bicycle lanes and lanes dedicated to buses that make the transit go much faster.”

Monkkonen points to Vancouver, Canada, as another potential model for Los Angeles. “It’s a place where single-family home neighborhoods have had the density increased without changing how it looks. In Vancouver, they have a basement unit, a ground-level unit and a second-floor unit. They look like single-family homes, but there are actually three households there.”

The only way to handle a constantly growing population, Monkkonen argued, is to set aside our neighborhood-based ideals and look at the region as a whole.

Like her colleagues, Ling sees the need to increase housing density in Los Angeles, but it is “equally important to require that this density be coupled with inclusionary zoning.
A proportion of this extra density must be built as affordable housing.”

In downtown Los Angeles, a boom in construction has brought gleaming new high-rises along with a handful of medium-density projects. Most people think downtown is better now, Ling said, but it’s not a model that works throughout the city.

A Tipping Point for California?

Where, then, should the new housing be built?

“That’s the question,” Ling said. “Where are we going to put it? If this planning was rational, we would put them where the density is most-suited, where people most want to live. But, in reality, issues like this are very much decided on the local level, neighborhood-by-neighborhood, district-by-district.”

In Monkkonen’s view, the best chance to solve California’s housing crisis lies at the state level. In his white paper, he says the state should take action by enforcing and enhancing existing laws, developing ways to make planning decisions at a metropolitan, not neighborhood, scale.

“As long as cities decide within their boundaries where to put the housing, it will work,” Monkkonen said of the idea. “The state would just say, ‘You must have housing,’ and enforce the rules if cities do not comply.”

The state has had rules on the books for 40 years to promote the creation of new housing, but they are rarely enforced. Perhaps California has reached a tipping point that would make state action more feasible?

“Oregon gets a lot of attention in planning scholarship,” Manville said. “They do have a very strong statewide land use program, where the state plays a very active role.”

California could do it too, even in places where resistance would be strong.

These ideas — stronger statewide leadership, looser zoning laws, smarter growth, improved transit, denser housing — are viewed by the UCLA Luskin faculty members as essential changes. Despite the disenchantment that spawned Measure S and similar outcries over growth, they remain generally upbeat about the region’s prospects for a more livable future.

In 20 years, Ling said, “I hope we would live comfortably and closely together, in a city were we don’t need to drive anymore because there will be autonomous cars that move us from our house to the transit station. I’d like L.A. to look like many of the arrondissements in central Paris, filled with six-story buildings in a walkable neighborhood.

“That’s what I would like to see. And we have to believe that it’s possible,” she said, pausing a moment to consider what may happen if the advice of planners like her continues to go unheard. “Otherwise, it could be very bad.”

Proud to be Part of the Luskin Community International students share their experiences, dreams and awareness of anxiety in an uncertain world

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By George Foulsham

Eri Suzuki, a Public Policy master’s student from Japan; JianChao Lai, a Social Welfare PhD student from China; and Jorge Loor, an Urban Planning master’s student from Ecuador — described the challenges faced by international students and their families in a world filled with anxiety.

What led you as an international scholar to choose California and the UCLA Luskin School of Public Affairs?

Suzuki: I worked at the Ministry of Education, Culture, Sports, Science and Technology in Japan. The Japanese government has a program that provides for government officials who have several years of work experience to study abroad. I was in charge of the Japanese National University division and my job was mainly to interpret the law of Japanese National Universities. And through working at the Higher Education Bureau in Japan I realized that there are so many problems in Japanese higher education policy, like tuition, scholarships, finance and budget at universities, especially since the Japanese economy is shrinking right now. So I started getting interested in studying in the U.S. because there are so many world-famous universities here. And I thought maybe as being a grad student I can learn hints or key factors that can be applied to Japanese universities. So I decided to apply to this program through the Japanese government.

Lai: I did my undergrad in social work in China. Social work is a newly developed major — we did not have it 30 years ago. It is fairly new and it’s not complete. So I went to America to study social work. I went to Wisconsin for my MSW. I love to come to large cities like New York and L.A., a more vibrant city feel, and also because of the reputation of UCLA. And I did some stalking online for professors and I found my adviser, Todd Franke. He really matches with my interests, and he is such a great mentor. So I decided to come here, and it’s been a great decision so far.

Loor: I was at a grad school fair when I was at the University of Texas — this was back in 2008 or 2009 — and this school (Luskin) was there. I was toying with this idea to go into urban studies at Texas. My degree is in civil engineering and I wanted something else so I added on history. While I was fulfilling the major I got into an urban studies class and I liked it. I always wanted to come back to L.A. and since I knew this school existed and this program existed, and I knew I wanted to come back to L.A., so I only applied to UCLA. I didn’t apply anywhere else because I know there is a certain prestige to the name. This was just a really good program.

There’s been a lot of talk about travel bans being instituted by our new president. Has that impacted your life in any way? What kinds of things are you hearing from family, friends and other international students about this issue?

Suzuki: As a government official at Japan’s Ministry of Education, I am really concerned about the ban’s effect in the near future on the interaction between Japanese and American students or researchers, or the number of Japanese people who want to study abroad here. They may decide not to come here because they realize maybe that the ban will affect getting a visa to come here.

Lai: The travel ban hasn’t impacted me or my family that much, but the new president’s attitude and actions toward women — cutting funding for Planned Parenthood and Violence Against Women Act, and science education and the EPA — some of my friends are directly influenced by those actions. As a female and a student researcher, that concerns me a lot — together with the travel ban. The globalization process is inevitable, and only through cooperation between countries can we make win-win situations. These actions may only cause hatred and discrimination, but can’t bring the good side of humankind.

Loor: Just tangentially because my mom went to Jordan a few weeks ago for a vacation with her sister. I was just worried about it, though there was no real problem. It is a bummer that you have to think about this. The ICE (Immigrant and Customs Enforcement) crackdowns are a big deal here in L.A. I haven’t been directly affected by it, but still I am just hyper aware because of the nature of what I am studying and the nature of the social consciousness of the cohort as a whole.

How has Luskin prepared you to deal with the challenges you may face upon graduation?

Suzuki: I have to return to the ministry of education so I have to continue working. I still am interested in higher education policy. So I really want to work in the higher education policy division but also at the same time my ministry is in charge of sports policy. In 2020 the Olympics Games are coming to Japan and we have the sports agency in the education ministry. So I want to help the city of Tokyo host the Olympic games in 2020. One thing that I learned here is a lot of quantitative analysis skill that I never learned in Japan. It was a really great opportunity for me to learn that skill. I really want to emphasize the importance of data when making education policies once I return to Japan.

Lai: I’m thinking about being a professor or researcher. I used to focus on the clinical side, but then I thought that is really limited, doing just therapy and counseling. I hope one day, using my research, I can actually advocate for those people who have been ignored in research or in services.

I think the resources that Luskin has provided are great: mentorship, the classes, the connections with other schools and other researchers that are related to my interests. That also helped prepare for my research and just doing independent work. And my social skills. And the supportive platform is really important. I felt really welcome here.

Loor: I will more than likely have to go into the private sector. I’ve taken Joan Ling’s three housing courses. For me, at least with my background in engineering, I’m well-suited to go into real estate development, hopefully with some affordable housing development component. Luskin really prepares you a lot. I was looking at jobs earlier this week, and I realized that I am qualified for real estate financial analyst, and I’d never thought about doing this for a career.

America in the Balance A Senior Fellows talk at UCLA Luskin by two political veterans reminds students that legislative success in America depends on compromise, not on who can yell the loudest  

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By Les Dunseith

Today, national politics is dominated by rancor, name-calling and partisanship. The pressure to pick a side and take up the battle against enemies on the political left or right can seem particularly intense for the students who study public policy at the UCLA Luskin School of Public Affairs.

But it doesn’t have to be that way. As former GOP gubernatorial candidate William “Bill” Simon reminded attendees during a Senior Fellows Lecture Series discussion on June 8, 2017, actually getting things done in politics requires compromise and consensus.

“I feel very strongly that there is a role for sensibility. There is a role for courtesy,” Simon told a group of UCLA Luskin students and faculty members. “You have to have courtesy for people who don’t agree with you.”

The value of being open-minded was particularly apt given that the spirited discussion took place on the UCLA campus and also included political strategist Dan Schnur, who is a faculty member at cross-town rival USC.

“It’s really easy to point to the most irrational and repulsive voices on the other side and use them as an excuse not to engage with someone who doesn’t agree with you,” Schnur said of the current political climate. “I remind people that someone who disagrees with me 80 percent of the time isn’t my enemy. She’s someone I can work with 20 percent of the time. And think of what we can accomplish in that 20 percent.”

Political strategist Dan Schnur: “I remind people that someone who disagrees with me 80 percent of the time isn’t my enemy. She’s someone I can work with 20 percent of the time.”

A wide-ranging Q&A session included discussions about volunteerism, student activism and speculation about the 2018 California governor’s race. The speakers addressed international issues like climate change. But the session was dominated by talk of the turmoil in Washington, D.C.

The gathering was organized by VC Powe, director of career services and leadership development, in part because of a request from students — some of them from other countries.

“College campuses like UCLA can be liberal-leaning, so it was great to see students come forward, asking for speakers who could talk about the current presidential administration from a more conservative and independent-thinking viewpoint,” Powe said. “We need to create more spaces like this for meaningful dialogue.”

Schnur is registered as a “no party preference” voter nowadays, but his resumé includes stints working as a communications director for Republican Sen. John McCain and a former GOP governor of California, Pete Wilson. Simon is a businessman and philanthropist who has co-taught a class at USC with Schnur and also serves as a visiting professor at UCLA in law and economics. He described himself during the UCLA gathering as an “unapologetic conservative Republican.”

Simon told the students that America is currently at an important intersection in history in which political consensus has eroded. He reminded them of another highly charged time of partisan politics.

“You had a conservative Republican like Ronald Reagan in the ’80s who could still get something done with a liberal Democrat like Tip O’Neill,” he said of the former president and House speaker, who ended up finding enough common ground to produce landmark reforms of welfare, taxes and Social Security. “And I think that has now been lost.”

The current political discord may turn out to be a historical aberration, Schnur said, pointing out that it’s a worthwhile reminder of what makes America unique. By happenstance, the UCLA session occurred on the same day as opening testimony by former FBI Director James Comey about whether President Donald Trump had acted improperly in seeking to derail an investigation of possible ties to Russia among Trump allies.

“A country’s chief executive is being questioned for what the head of our domestic law enforcement agency called ‘deeply disturbing behavior,’ and there is a constitutional process in place for another branch or branches of government to check that behavior should it become necessary,” Schnur said. “Whether you are a Republican or a Democrat, whether you are a no party preference or a Green or a Libertarian or a vegetarian, you ought to be able to take some real comfort, if not some real pride, in the idea … that there is a process and a system in place to address these potential excesses in a completely appropriate and legal and constitutional manner.”

Both Schnur and Simon said the country’s political divide certainly is being exacerbated by the actions and behavior of Trump.

“This is as much hatred as I have ever seen for a person in the political arena. And I think that’s too bad,” said Simon, who noted that he personally dislikes the president and questions his tactics despite agreeing with certain actions, including his choice of Neil Gorsuch to join the U.S. Supreme Court.

“But 62 million people voted for Trump. So obviously there is something going on,” Simon said.

He said many people who voted for Trump did so because they felt like their views had been overlooked.

“They didn’t trust anybody that got elected, Republican or Democrat. It was just a way of protesting the establishment,” Simon suggested. “It wasn’t so much that Trump resonated with them politically. Trump resonated with them emotionally. Because he was angry.”

Schnur said he also is no fan of Trump. He thinks the current political gridlock in Washington likely will be transitory and noted that the 2016 election result is already motivating party leaders to rethink policy positions and election strategy. Perhaps the end result will be a more thoughtful, reflective American electorate.

“Politics doesn’t lead society. Politics reflects society,” he said.

Schnur pulled out his cellphone and spoke about the wonderful sense of freedom and empowerment it provides to him, noting the near-constant flow of information and access to entertainment, ideas and opinions.

Then he pointed to the ear buds.

“As soon as I put these plugs in my ears to listen to my favorite music, I immediately lose any interest in what you are listening to,” Schnur said, motioning toward Simon as he continued the metaphor. “If I have one set of cable stations, and he has another. If I have one set of podcasts and websites, and he has another … we are not just disagreeing on the issues of the day. We are experiencing two entirely different versions of reality.”

Turning back to the gathering of students and faculty, and hinting at their desire to weather the current political storm and pursue careers that improve American policy, Schnur continued.

“What can we do? We can take the plugs out of our ears.”

Social Workers and Medical Students: ‘The Ideal Team’ UCLA Luskin’s Department of Social Welfare provides lessons in social work to first-year students from the David Geffen School of Medicine at UCLA

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By George Foulsham

Matthew Hing is a first-year medical student at UCLA, but on this April morning he’s a visitor in a nondescript building on Lincoln Boulevard in Venice — the St. Joseph Center, home of the Chronically Homeless Intervention Program.

Hing enters through a back door, weaving through a crowd of homeless people who gather each morning to take advantage of St. Joseph’s services. This isn’t your typical med school classroom, but Hing believes the experience will be a vital part of his training — adding more educational insight to his medical school curriculum.

Thanks to a partnership between the UCLA Luskin School of Public Affairs’ Department of Social Welfare and the David Geffen School of Medicine at UCLA, Hing and 19 other medical students are receiving a lesson in social work.

A month earlier, the students gathered in a classroom in the Public Affairs building for an orientation session arranged by Todd Franke, the chair of the Department of Social Welfare; Gerry Laviña MSW ’88, director of field education at UCLA Luskin; and Michelle Talley MSW ’98, a member of UCLA Luskin’s field education faculty and a licensed clinical social worker (LCSW).

“I think this is a fantastic opportunity,” Franke said as he greeted the students. “We hope this is a marvelous success.”

Laviña talked about how much he learned from similar experiences earlier in his career. “I learned so much from the doctors and nurses and social workers,” he said. “Literally, I would not be here today if I hadn’t had that experience.”

Talley told the students about having worked in child welfare, and how she spent time working with public health nurses on adoption cases. “It was very helpful and useful in my role as a social worker, understanding some of the medical issues that a child could be faced with,” she said.

Michelle Talley, left, a member of UCLA Luskin’s field education faculty and a licensed clinical social worker, speaks to medical students during the orientation session held at the UCLA Luskin School of Public Affairs. Photo by George Foulsham

Hing’s day at the homeless center was the “shadowing” piece of the social work lesson. He spent a day observing and debriefing social workers and a psychiatrist, all of whom specialize in tending to the needs of the homeless.

“The psychiatrist, he saw three clients — all very different cases,” Hing said. “One was an intake case, the second time he had seen the client, so he was really getting a sense of what was going on — what had led to this individual becoming homeless, and how they were doing now.

“The second was much more stable — he’s been seen for several months — but there were new stresses in his life,” Hing said. “It was just a lot of things that a psychiatrist knew to ask that I never knew about.”

The third case involved a patient who was struggling with the anti-psychotic medication that she was taking, and how it was making her fall asleep. “So she was worried about her safety on the street,” he said. “This was something for me in a patient interaction that I would never think about, but you can learn from a social worker. Seeing those unique insights at work in this population — that’s what I got from shadowing.”

Hing shadowed those working with the homeless, and his fellow students had a variety of other experiences. One participated in a forensic interview on a child-abuse case — “an intense experience,” Hing said he heard later.

Hing’s trip to St. Joseph Center was arranged by Laviña, and the two have been the driving forces behind making the partnership a reality. After attending a conference about social medicine in October, Hing emailed a proposal for the program to members of the curriculum committee at the Geffen School. He and his colleagues, fellow medical students Amrita Ayer, Brian Dang, Lyolya Hovhannisyan and Samantha Mohammad, produced a potential syllabus, which led to a formal presentation to UCLA Luskin.

After emailing Laviña and Franke, Hing received an overwhelmingly positive response.

“Todd thought it was an excellent idea,” Hing said. “He wondered why it hadn’t already happened, and was excited about the possibilities.”

The concept resonated with Laviña, who sees it as a logical extension of what social welfare experts provide to Luskin’s master’s students.

“Social workers have always worked in multidisciplinary settings, so we strive for collaboration with physicians and all other disciplines,” Laviña said. “We were happy to work with Matt and his peers, along with our faculty and panelists, to bring very direct feedback as to how they can become doctors who work with their patients and families using cultural humility and truly seeking a holistic approach.”

The orientation session was the first part of the program. In addition to the introductions by Laviña, Franke and Talley, the session included a panel of seven social welfare experts: Rosella Youse, a manager with the Los Angeles County Department of Children and Family Services (DCFS); Kim Tran MSW ’11, a forensic interviewer with DCFS who is stationed at Harbor UCLA Medical Center; Deborah Tuckman MSW ’99, a social worker in the emergency department at Cedars-Sinai; Thomas Pier, LCSW at Simms/Mann UCLA Center for Integrative Oncology; Brian C. Wren, LCSW at Providence Health & Services; James Coomes MSW ’96, LCSW at the county department of mental health; and Kim Griffin-Esperon MSW ’98, LCSW with the Los Angeles Unified School District.

The experts shared stories about dealing with child abuse, testifying in court for child welfare and neglect cases, helping assist children with spina bifida and cancer, providing guidance on home health care and about coping with many other social issues doctors might encounter during their careers.

“You won’t know child welfare social work like we do,” Youse told the medical students. “But I don’t know the medical field like you do. So together we are really the ideal team.”

The program is also supported by those who work with the students in the Geffen School.

“Caring for patients takes a diverse team of experts,” said Sheila Naghshineh, chair of the doctoring program for first-year medical students. “Having a social worker on the team is often vital to providing high-quality, customized care for patients in both the outpatient and inpatient setting.”

It is important for health care providers to understand the role of social workers so that they can learn to work together as a team, Naghshineh said. “The social worker shadowing pilot program helps medical students experience first-hand how to effectively work with social workers, and understand how and when to utilize their services, resources and expertise to benefit patients,” she said.

Asked if he thinks social work should be a part of the medical students’ curriculum, Hing’s response was definitive: “Yes, yes, yes.”

“Ideally, this should be part of our curriculum,” said Hing, who was raised in a medical family — his mother is a social worker and his father is a physician. “I think it is important for us to witness the empathy that social workers bring forth for their patients, who are often from the most vulnerable, marginalized parts of our society. I’d love to make sure that all of my classmates have this opportunity to see the incredible work that is going on around this.”

Laviña said he was inspired to witness and experience the students’ openness to the feedback. “I am heartened to think about the type of doctors they will become — and how they will better serve our communities,” he said.