Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-09T19:57:44.378Z Has data issue: false hasContentIssue false
  • English
  • Français

Technologies for the Delivery of Mental Health Care

Published online by Cambridge University Press:  10 March 2009

David Mechanic
David Mechanic
Affiliation:
Rutgers University
Get access Rights & Permissions [Opens in a new window]

Abstract

Mental health services depend both on efficacious drug and interpersonal interventions and strategies for financing, organizing, and delivering these services. In recent years, much attention has been devoted to approaches that seek to coordinate needed care and to provide it in the most cost-effective ways. Cost constraints encourage the substitution of alternative community treatments for expensive inpatient care and the identification of appropriate ways to link effectively the varying care components. The mechanism most commonly advocated is case management, but the concept is applied in diverse ways and has little agreed upon meaning and disparate outcomes. This paper discusses and evaluates concepts of case management and a variety of other systems interventions designed to reduce fragmentation. It also reviews approaches to managed care, including mental health capitation and utilization management. New organizational technologies are likely to change dramatically professional practices and standards and the future provision of mental health care.

Type
Special Section: The Assessment of Psychiatry
Information
International Journal of Technology Assessment in Health Care , Volume 12 , Issue 4 , Fall 1996 , pp. 673 - 687
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Babigian, H. M., & Marshall, P. E. Rochester: A comprehensive capitation experiment. In Mechanic, D. & Aiken, L. (eds.), Paying for services: Promises and pitfalls of capitation. New Directions in Mental Health Services, No. 43. San Francisco: Jossey-Bass, 1989, 43–54.Google Scholar
2.Boyer, C., & Mechanic, D.Psychiatric reimbursement reform in New York State: Lessons in implementing change. Milbank Quarterly, 1994, 72, 621–51.CrossRefGoogle ScholarPubMed
3.Breier, A., Schreiber, J., Dyer, J., et al. National Institute of Mental Health longitudinal study of chronic schizophrenia. Archives of General Psychiatry, 1991, 48, 239–46.CrossRefGoogle ScholarPubMed
4.Carone, B. J., & Westermeyer, J. F.Posthospital course and outcome in schizophrenia. Archives of General Psychiatry, 1991, 48, 247–53.CrossRefGoogle ScholarPubMed
5.Christianson, J. B., Lurie, N., Finch, M., et al. Mainstreaming the mentally ill in HMOs. In Mechanic, D. & Aiken, L. (eds.), Paying for services: Promises and pitfalls of capitation. New Directions in Mental Health Services, No. 43. San Francisco: Jossey-Bass, 1989, 19–28.Google Scholar
6.Christianson, J. B., Lurie, L., Finch, M., et al. Use of community-based mental health programs by HMOs: Evidence from a Medicaid demonstration. American Journal of Public Health, 1992, 82, 790–96.CrossRefGoogle ScholarPubMed
7.Dietzen, L., & Bond, G.Relationships between case manager contact and outcomes for frequently hospitalized psychiatric clients. Hospital and Community Psychiatry, 1993, 44, 839–43.Google ScholarPubMed
8.Frank, R. G., McGuire, T. G., & Newhouse, J. P.Risk contracts in managed mental health care. Health Affairs, 1995, 14, 51–64.CrossRefGoogle ScholarPubMed
9.Goldman, H. H., Lehman, A. F., Morrissey, J. P., et al. Design for the national evaluation of the Robert Wood Johnson Foundation program on chronic mental illness. Hospital and Community Psychiatry, 1990, 41, 1217–21.Google Scholar
10.Goldman, H. H., Morrissey, J. P., & Ridgely, M. S.Form and function of mental health authorities at Robert Wood Johnson Foundation program sites: Preliminary observations. Hospital and Community Psychiatry, 1990, 41, 1222–30.Google Scholar
11.Goldman, H. H., Morrissey, J. P., & Ridgely, M. S.Evaluating the Robert Wood Johnson Foundation program on chronic mental illness. Milbank Quarterly, 1994, 72, 37–47.CrossRefGoogle Scholar
12.Harding, C. M., Brooks, G. W., & Ashikaga, T., et al. The Vermont longitudinal study of persons with severe mental illness, II: Long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. American Journal of Psychiatry, 1987, 144, 727–35.Google ScholarPubMed
13.Harding, C. M., Zubin, J., & Strauss, J. S.Chronicity in schizophrenia: Fact, partial facts or artifact? Hospital and Community Psychiatry, 1987, 38, 477–86.Google ScholarPubMed
14.Hatfield, A. (ed.). Families of the mentally ill: Meeting the challenges. New Directions in Mental Health Services, No. 34. San Francisco: Jossey-Bass, 1987.Google Scholar
15.Hogarty, G., Anderson, C., Reiss, D., et al. Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia, II: Two-year effects of a controlled study on relapse and adjustment. Archives of General Psychiatry, 1991, 48, 340–47.CrossRefGoogle Scholar
16.Jencks, S. F., Horgan, C., Goldman, H., et al. Bringing excluded psychiatric facilities under the medicare prospective payment system: A review of research evidence and policy options. Medical Care, 1987, 25, Supplement no. 9.Google ScholarPubMed
17.Kessler, R. C., McGonagle, K. A., Zhao, S., et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Study. Archives of General Psychiatry, 1994, 51, 8–19.CrossRefGoogle Scholar
18.Kiesler, C. A., & Sibulkin, A. E.Mental Hospitalization: Myths and facts about a national crisis. Newbury Park, CA: Sage, 1987.Google Scholar
19.Kiesler, C. A., & Simpkins, C. G.The unnoticed majority in psychiatric inpatient care. New York: Plenum, 1993.CrossRefGoogle Scholar
20.Leff, J., & Vaughn, C.Expressed emotion in families. New York: Guilford Press, 1985.Google Scholar
21.Lefley, H.Expressed emotion: Conceptual, clinical and social policy issues. Hospital and Community Psychiatry, 1992, 43, 591–98.Google ScholarPubMed
22.Lehman, L.Capitation payment and mental health care: A review of the opportunities and risks. Hospital and Community Psychiatry, 1987, 38, 31–38.Google ScholarPubMed
23.Lurie, N., Moscovice, I., Finch, M., et al. Does capitation affect the health of the chronically mentally ill? Results from a national trial. Journal of the American Medical Association, 1992, 267, 3300–04.CrossRefGoogle Scholar
24.Manning, W. G., & Wells, K. B.Preliminary results of a controlled trial of the effect of a prepaid group practice on the outpatient use of mental health services. Journal of Human Resources, 1986, 21, 293–320.CrossRefGoogle Scholar
25.Manning, W. G., Wells, K. B., & Benjamin, B.Use of outpatient mental health care: Trial of a prepaid group practice versus fee-for-service. Publication no. R-3277-NIMH. Santa Monica: Rand Corporation, 1986.Google Scholar
26.Manning, W. G., Wells, K. B., & Benjamin, B.Use of outpatient mental health services over time in a health maintenance organization and fee-for-service plans. American Journal of Psychiatry, 1987, 144,283–87.Google Scholar
27.Mauch, D.Rhode Island: An early effort at managed care. New Directions in Mental Health Services, No. 43. San Francisco: Jossey-Bass, 1989, 55–64.Google ScholarPubMed
28.Mechanic, D. Key policy considerations for mental health in the managed care era. United States Department of Health and Human Services, Mental Health, United States, 1996, in press.CrossRefGoogle Scholar
29.Mechanic, D.Strategies for integrating public mental health services. Hospital and Community Psychiatry, 1991, 42, 797–801.Google ScholarPubMed
30.Mechanic, D.Treating mental illness: Generalist versus specialist. Health Affairs, 1990, 9, 61–75.CrossRefGoogle ScholarPubMed
31.Mechanic, D., & Aiken, L. (eds.) Paying for services: Promises and pitfalls of capitation. New Directions in Mental Health Services, No. 43. San Francisco: Jossey Bass, 1989.Google Scholar
32.Mechanic, D., McAlpine, D., Rosenfield, S., et al. Effects of illness attribution and depression on the quality of life among persons with chronic mental illness. Social Science & Medicine, 1994, 39, 155–64.CrossRefGoogle Scholar
33.Mechanic, D., & Surles, R.Challenges in state mental health policy and administration. Health Affairs, 1992, 11, 34–50.CrossRefGoogle ScholarPubMed
34.Mechanic, D., Schlesinger, M., & McAlpine, D.Management of mental health and substance abuse services: State of the art and early results. Milbank Quarterly, 1995, 73,19–55.CrossRefGoogle ScholarPubMed
35.National Advisory Mental Health Council. Health care reform for Americans with severe mental illnesses. American Journal of Psychiatry, 1993, 150, 1447–65.CrossRefGoogle Scholar
36.New South Wales Department of Health. Psychiatric hospital versus community treatment: A controlled study. Publication no. HSR 83–046. Sidney, Australia: New South Wales Department of Health, 1983.Google Scholar
37.Olfson, M.Assertive community treatment: An evaluation of the experimental evidence. Hospital and Community Psychiatry, 1990, 41, 634–41.Google ScholarPubMed
38.Olfson, M., Glick, I. D., & Mechanic, D.Inpatient treatment of schizophrenia in general hospitals. Hospital and Community Psychiatry, 1993, 44, 40–44.Google ScholarPubMed
39.Rogers, W. H., Wells, K. W., Meredith, L. S., et al. Outcomes for adult outpatients with depression under prepaid or fee-for-service financing. Archives of General Psychiatry, 1993, 50, 517–25.CrossRefGoogle ScholarPubMed
40.Rosenfield, S.Factors contributing to the subjective quality of life of the chronic mentally ill. Journal of Health and Social Behavior, 1992, 33, 299–315.CrossRefGoogle Scholar
41.Rosenfield, S., & Neese-Todd, S.Elements of a psychosocial clubhouse program associated with a satisfying quality of life. Hospital and Community Psychiatry, 1993, 44, 76–78.Google ScholarPubMed
42.Russell, L.Medicare's new hospital payment system: Is it working? Washington, DC: The Brookings Institution, 1989.Google Scholar
43.Salit, S. A., and Marcos, L. R.Have general hospitals become chronic care institutions for the mentally ill? American Journal of Psychiatry, 1991, 148, 892–97.Google ScholarPubMed
44.Stein, L. I. Wisconsin system of mental health financing. In Mechanic, D. & Aiken, L. (eds.), Paying for services: Promises and pitfalls of capitation. New Directions in Mental Health Services, No. 43. San Francisco: Jossey Bass, 1989, 29–41.Google Scholar
45.Stein, L. I., & Ganser, L. J. Wisconsin system for funding mental health services. In Talbott, J. (ed.), New directions for mental health services: Unified mental health system. San Francisco: Jossey-Bass, 1983, 25–32.Google Scholar
46.Stein, L. I., & Test, M. A.Alternatives to mental hospital treatment, I: Conceptual model, treatment program and clinical evaluation. Archives of General Psychiatry, 1980a, 37, 392–97.CrossRefGoogle ScholarPubMed
47.Stein, L. I., & Test, M. A.Alternatives to mental hospital treatment, III: Social cost. Archives of General Psychiatry, 1980b, 37, 409–12.Google Scholar
48.Stein, L. I., & Test, M. A.The Training in Community Living model. New Directions in Mental Health, No. 2627. San Francisco: Jossey-Bass, 1985.Google ScholarPubMed
49.Wells, K. B., Manning, W. G., & Burciaga Valdez, R.The effects of a prepaid group practice on mental health outcomes of a general population. Publication no. R-3834-NIMH/HCFA. Santa Monica: Rand Corporation, 1989.Google Scholar