Managing care for mental illness: paradox and pitfalls

Historically mental health has been separated from physical health care, and within mental health there have been largely separate public and private systems. A managed care approach now offers the potential of integrating and rationalizing mental health care. Counihan et al. and Stelovich represent the historical forces of mental health and health care, playing out as the two key models of managed care: the carve-out and the integrated model. However, the advent of managed care in today's health care system also presents significant dangers, particularly for vulnerable populations such as adults and children with severe and longterm mental disorders.