The Pros and Cons of Managed Mental Health Care

Abstract
This paper will discuss the different effects managed care has on the quality of mental health care for its clients. On the positive, managed care has increased availability to a cliental that would otherwise not be able to afford mental health care. On the negative, there has been a reduction in quality in order for managed care corporations to keep costs low and still make money. Proper implementation of managed mental health care would likely result in high quality, low cost mental health care.

Introduction
Two decades ago hospitals were for the physically ill and asylums were for the mentally ill. With the stigma fading from mental illness and a movement toward deinstitutionalization, this paradigm of segregation of mental and physical health care does not hold true today. A direct effect of the paradigm shift is a greater willingness on the part of the public to seek help for mental health problems. (Madonna, 2000, ¶ 6) Managed care has stepped up to fill the increasing need for inexpensive mental health care coverage.
Each year, 52 million Americans have some form of mental health problem and out of those patients 60% are members of a managed care group. (Madonna, 2000, ¶ 8) Managed mental health care’s successes and failures now bear directly on the mental wellbeing of 32 million particularly vulnerable Americans. Initially managed care was intended to be a “comprehensive approach to healthcare that included balancing cost, quality, utilization, and access.” (Madonna, 2000, ¶ 23) In theory, this is an optimal approach to the delivery of health care and it has proven somewhat successful in the area of physical health, but it has not provided the same success in the area of mental health. Mental health is still being treated as a separate and less important aspect of health care despite the fact that some mental health disorders, such as schizophrenia, have shown higher success rates than those of common medical procedure, such as angioplasty. (Etheredge, 2002, ¶ 6)
The Cons
First and foremost managed mental health care is a business and good business often prevents good medicine. Theoretically, a well implemented managed care could work well, but in order to make their stockholders happy, managed care companies do not always implement policies to help the patient. An example of this would be the common policy of company personnel making tre...

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...business. Also, the government needs to step up and pass legislation that puts more pressure on employers to include mental health coverage. Legislation pertaining to parity was a step forward, but an employer currently can simply drop mental health coverage to circumvent the laws. Finally, it is the duty of practitioners to serve the patients best interest, not that of the managed care company. Practitioners must put pressure on managed mental health care companies to place power back into the hands of the mental health professional who provide care for the patients daily. Patients are people not numbers.

References
Coleman, M. (2003). Behind managed care’s courtship of clinical social workers. Behavioral Heath Management, 23, 36-37.
Madonna, T. (2000). Providing mental health services under managed care arrangements. Hospital Topics, 78, 23-27.
Bernard, D. & Shulkin, D. (1998). The media vs. managed health care. Archives of Internal Medicine, 158, 2109-2111.
Alexander, E. (1997). Gags rules and trade secrets in managed care contracts. Archives of Internal Medicine, 157, 2037-2043.
Etheredge, J. (2002). Misperceptions behind mental health policy. JAMA, 287, 1858-1859.