Collision or collaboration? School-based health services meet managed care

Area of Science:

• Public Health
• Health Services Research
• Child and Adolescent Psychiatry

Background:

• Not-for-profit school mental health programs affiliated with school-based health centers (SBHCs) interact with for-profit managed-care organizations (MCOs).
• Established relationships exist between MCOs and traditional mental health services, but not with SBHCs.
• The landscape of child and adolescent mental health services is evolving with the rise of managed care.

Purpose of the Study:

• To describe the interactions, developments, and challenges between SBHCs and MCOs.
• To examine the role of advocacy groups in shaping policy for SBHCs within managed care.
• To outline recommendations for meeting the mental health needs of underserved children through SBHCs.

Main Methods:

• Qualitative analysis of interactions between SBHCs and MCOs.
• Case study of Connecticut's approach to SBHC-MCO dialogue.
• Review of legislative actions and advocacy group strategies.

Main Results:

• SBHC-MCO relationships are not yet well-established, presenting unique challenges.
• Advocacy groups successfully influenced legislation to protect SBHCs' role in managed care.
• Connecticut's experience highlights a pathway for dialogue and policy development.

Conclusions:

• Ensuring access to school-based mental health services requires ongoing collaboration between SBHCs and MCOs.
• Policy safeguards and advocacy are essential for protecting vulnerable children's mental health care.
• Addressing the mental health needs of underserved children necessitates strategic planning and resource allocation within managed care frameworks.