A Specialized Mental Health Plan for Persons With Severe Mental Illness Under Managed Competition

Scheffler, Richard M.; Grogan, Colleen M.; Cuffel, Brian J.; Penner, Susan

doi:10.1176/ps.44.10.937

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…In 1990 Dorwart (332) discussed myths about managed mental health care, including that managed care caused, and that managed care would cure, the current problems of mental health care. Throughout the 1990s managed mental health care rolled itself out, first on the private side and then on the public (333)(334)(335)(336)(337)(338)(339)(340)(341)(342)(343)(344)(345)(346)(347)(348)(349)(350).…”

Section: Economicsmentioning

confidence: 99%

The Last Half-Century of Psychiatric Services as Reflected in Psychiatric Services

Geller¹

2000

132

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The last half-century of psychiatric services in the United States is examined through developments and trends reported in the 50 years of publication of Psychiatric Services. The journal, earlier named Mental Hospitals and then Hospital and Community Psychiatry, was launched by the American Psychiatric Association in January 1950 and marks its 50th anniversary this year. The author organizes his review of psychiatric services largely around the locus of care and treatment because the location of treatment--institution versus community--has been the battleground for the ideology of care and for the crystallization of policy and legal reform. He uses "dehospitalization" to describe the movement of patients out of state hospitals, rejecting the widely used term "deinstitutionalization" as inappropriate; one reason is that the term wrongly implies that many settings where patients ended up were not institutional. Also covered in detail, as reflected in the journal, are community care and treatment, economics, patient empowerment, and the interface issues of general hospitals, outpatient commitment, and psychosocial rehabilitation. The author notes that some concepts, such as outpatient commitment and patient empowerment, emerged earlier than now assumed, and that others, like psychosocial rehabilitation, recurred in slightly different forms over time. He concludes that even after 50 years of moving patients out of state hospitals and putting them somewhere else, mental health policymakers and practitioners remain too myopically focused on the locus of care and treatment instead of on the humaneness, effectiveness, and quality of care.

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Section: Economicsmentioning

confidence: 99%

The Last Half-Century of Psychiatric Services as Reflected in Psychiatric Services

Geller¹

2000

132

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“…The overall care may best be coordinated by the mental health professional, with the primary care clinician serving as a consultant/team member. The concept of a Mental Health Maintenance Organization makes sense in this context (Scheffler, Grogan, Cuffel, & Penner, 1993).…”

Section: Mental Health Services In Primary Carementioning

confidence: 99%

Mental healthcare in the primary care setting: A paradigm problem.

deGruy¹

1997

Families, Systems, & Health

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In this article, I make the case that a major portion of mental healthcare is rendered in the primary care setting, and always will be, sometimes despite strong disincentives; that a sensible vision of primary healthcare must have mental healthcare woven into its fabric; that the primary care setting is well suited to the provision of most mental health services; that despite suboptimal recognition and management of mental disorders and attention to mental health, the structure and operation of primary care can be modified so as to greatly augment the provision of these services; and that the current efforts underway in the US to reform the healthcare system offer an opportunity to find the most effective of these modifications, and to discover fruitful collaborative structures both within the primary care setting and between primary care clinicians and mental health professionals.

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“…To be effective, efforts to develop managed care organizations in the delivery of public sector mental health services should involve a higher level of coordination among federal, state, and local funding bodies. Managed care plans for the public sector that have considered some of the complexities of the citizen-government relationship have been developed in papers by Scheffier and others (Scheffier, Grogan, Cuffel, & Penner, 1993;Scheffier, Foreman, Cuffel, & Mackely, 1993).…”

Section: Citizen-taxpayer~ Government Relationshipmentioning

confidence: 99%

Managed care in the public mental health system

Cuffel

Snowden

Masland³

et al. 1996

Community Ment Health J

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The movement towards managed care in the public mental health system has surpassed efforts to develop a systematic literature concerning its theory, practice, and outcome. In particular little has been written about potential challenges and difficulties in translating managed care systems from their origins in the private sector to the delivery of public sector mental health services. This paper provides an overview of managed care definitions, organizational arrangements, administrative techniques, and roles and responsibilities using a theoretical framework adopted from economics referred to as principal-agent theory. Consistent with this theory, we assert that the primary function of the managed care organization is to act as agent for the payor and to manage the relationships between payors, providers, and consumers. From this perspective, managed care organizations in the public mental health system will be forced to manage an extremely complex set of relationships between multiple government payors, communities, mental health providers, and consumers. In each relationship, we have identified many challenges for managed care including the complexity of public financing, the vulnerable nature of the population served, and the importance of synchronization between managed care performance and community expectations for the public mental health system. In our view, policy regarding the role of managed care in the public mental health system must evolve from an understanding of the dynamics of government-community-provider-consumer "agency relationships".

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A Specialized Mental Health Plan for Persons With Severe Mental Illness Under Managed Competition

Cited by 10 publications

References 27 publications

The Last Half-Century of Psychiatric Services as Reflected in Psychiatric Services

The Last Half-Century of Psychiatric Services as Reflected in Psychiatric Services

Mental healthcare in the primary care setting: A paradigm problem.

Managed care in the public mental health system

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