Primary therapists' views of managed care

Area of Science:

• Mental Health Services Research
• Healthcare Management
• Public Health Policy

Background:

• New York State Office of Mental Health implemented a Prepaid Mental Health Plan.
• Outpatient departments were reconfigured into comprehensive resource and treatment centers.
• The goal is to optimize patient recovery within a deregulated, capitated environment.

Purpose of the Study:

• To assess the comprehensiveness of public managed mental health care provision.
• To identify specific areas of difficulty in service provision and arrangement.
• To understand the underlying reasons (access, information, quality, supply) for these difficulties.

Main Methods:

• Survey of primary therapists (n=54) at South Beach Psychiatric Center's outpatient departments.
• Therapists rated the difficulty of providing/arranging services in 19 areas.
• Therapists identified the fundamental problem as access, information, quality, or supply.

Main Results:

• The five most difficult areas were: housing/residential services, substance-abuse services, dental care, general health care, and employment/vocational services.
• The primary reason cited for difficulty across these areas was 'supply'.
• This indicates a potential gap in the availability of essential support services.

Conclusions:

• Capitated managed care contracts may incentivize increased supply of critical mental health support services.
• Addressing supply-side limitations is crucial for comprehensive mental health care delivery.
• Further research into managed care's impact on service availability is warranted.