Managed mental health care for seriously mentally ill populations

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Abstract
Privatization of health care and the diminishing role of the ‘state’ in the public's health are the most pressing issues in behavioral health care reform today. This review provides a brief summary of the US experience with managed mental health care in privately insured populations, followed by experiences with public sector populations via ‘demonstration programs’, and more recent findings from statewide demonstration programs including larger numbers of public sector clients. In addition, a description of European reforms that equate to ‘managed care’ is given. The paper addresses the question of whether managed care strategies, used to effect reductions in use and cost of mental health care in the ‘privately’ insured US population, can be duplicated without adverse consequences in ‘public sector’ populations.