Evolution of services for the chronically mentally ill in a managed care setting: a case study

Managed care plans have expanded to serve individuals with severe and chronic mental illness over the past 25 years. During that time, the evolution of several key clinical phases has been witnessed: the creation of a diverse spectrum of services; the development of treatment algorithms; and the implementation of treatment outcomes measures as a way to gauge program success and develop future strategies. At the same time, a number of additional factors have had a significant impact upon the development of clinical programs targeted toward the chronically mentally ill: dollars allocated to mental health services; the influence of different models of delivery; and the incentives inherent in various methods of payment.