Mental health services then and now

nstitute for Health, Health Care Policy, and Aging Research, State University of New Jersey, New Brunswick, USA.
Health Affairs (Impact Factor: 4.97). 11/2007; 26(6):1548-50. DOI: 10.1377/hlthaff.26.6.1548
Source: PubMed


Over the past twenty-five years, psychiatric services have shifted from hospital to community. Managed care reinforces this trend. Mental illness is better understood and less stigmatized, and services are more commonly used. But many in need do not receive care consistent with evidence-based standards, or at all. Challenges are greatest for people with serious and persistent mental illnesses who depend on generic health and welfare programs and integrated services. Evidence-based rehabilitative care is often unavailable. Failures in community care lead to arrest; jail diversion and treatment are required. Despite progress, implementing an effective, patient-centered care system remains a formidable challenge.

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    • "45). See also Birenbaum (1997); Dranove (2000); Mechanic (2007); Morreim (1995a), (1995b); Scott et al. (2000). 2. I use the shorthand terms " managed care model " and " managed care approach " in this paper to characterize the overarching ideological and practical contours of managed mental health care in the United States, specifically, the primacy placed on cost effectiveness, efficiency, and predictability of outcomes. "
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