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OBJECTIVE:To quantify the magnitude of general medical and/or pharmacy claims expenditures for individuals who use behavioral health services and to assess future claims when behavioral service use persists. MEASUREMENTS: Claims expenditures for behavioral health services, general medical services, and prescription medications. MAIN RESULTS:Just over one tenth of enrollees (10.7%) in 2001 had at least 1 behavioral health claim and accounted for 21.4% of total general medical, behavioral health, and pharmacy claims expenditures. Costs for enrollees who used behavioral health services were double that for enrollees who did not use such services. Almost 80% of health care costs were for general medical services and medications, two thirds of which were not psychotropics. Total claims expenditures in enrollees with claims for both substance use and mental disorders in 2000 were 4 times that of those with general medical and/or pharmacy claims only. These expenditures returned to within 15% of nonbehavioral health service user levels in 2001 when clinical need for behavioral health services was no longer required but increased by another 37% between 2000 and 2001 when both chemical dependence and mental health service needs persisted. CONCLUSIONS:The majority of total claims expenditures in patients who utilize behavioral health services are for medical, not behavioral, health benefits. Continued service use is associated with persistently elevated total general medical and pharmacy care costs. These findings call for studies that better delineate: 1) the interaction of general medical, pharmacy, and behavioral health service use and 2) clinical and/ or administrative approaches that reverse the high use of general medical resources in behavioral health patients. T he evaluation and treatment of mental disorders causing emotional or behavioral difficulties and/or chemical dependence, collectively known as behavioral health disorders, have been effectively separated from the evaluation and treatment of general medical disorders. Most of those with health care coverage for behavioral health needs are served by managed behavioral health organizations.1,2 These management companies operate autonomously either from the managed medical care organization administering general medical benefits to the same patients (a behavioral health carve-out) or from the parent managed care organization which owns the behavioral health business (a behavioral health carve-in) but still manages behavioral health work processes (networks, care management, claims, etc.) separately. In practice, there is little difference between the two in the way that they service behavioral health needs. As a result of the widespread administrative separation of these two areas of health care, few studies have focused on the interaction of general medical, pharmacy, and behavioral health service use in those receiving behavioral health treatment. This article expands on our current understanding of the magnitude, persistence, and interaction of behavioral h...

This study examined the structure, internal consistency, and construct validity of the ClassMaps Survey, a measure of classroom characteristics that are related to students’ resilience and classroom success. Participants were 1,019 fifth- through eighth-grade science students who completed the ClassMaps Survey, a survey describing their classroom engagement, and three surveys describing their attitudes about science learning after being in their science class for 6 months. Results confirmed that the survey’s items factored into the predicted subscales and that the subscales’ internal consistency was adequate. Although significant grade and gender effects were noted, the effect sizes were uniformly small. Subscales of the ClassMaps Survey correlated as predicted with the four additional scales. Results suggest that the ClassMaps Survey is a promising measure of the characteristics of classrooms that promote resilience.

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As a new professor of measurement and statistics at Rutgers University in the early 1930s, Oscar Krisen Buros recognized the increasing importance of standardized testing to industrialized societies. In order to insure greater public accountability for tests and to evaluate the many claims being made by test authors and publishers, Buros created the Mental Measurements Yearbook (MMY) series. During an editorship that would last over 40 years, Buros recruited a cadre of skilled professionals to write “candidly critical” test reviews that would serve a variety of public interests. For test users, the series would allow valuable access to the expertise of scholars and professionals. Buros believed that knowledgeable test users would gradually become informed consumers of testing products and would select tests that met or exceeded minimal standards of psychometric adequacy. For test writers and publishers, Buros maintained that the publication of critical reviews would “cause authors and publishers to publish fewer but better tests” (Buros, 1938).