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... ... middle of paper ... ...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.
Pollack, Harold. "What Happened to U.S. Mental Health Care after Deinstitutionalization." Washingtonpost.com. N.p., 12 June 2013. Web. 13 Nov. 2013.
The fight for improved health care for those with mental illness has been an ongoing and important struggle for advocates in the United States who are aware of the difficulties faced by the mentally ill and those who take care of them. People unfortunate enough to be inflicted with the burden of having a severe mental illness experience dramatic changes in their behavior and go through psychotic episodes severe enough to the point where they are a burden to not only themselves but also to people in their society. Mental institutions are equipped to provide specialized treatment and rehabilitative services to severely mentally ill patients, with the help of these institutions the mentally ill are able to get the care needed for them to control their illness and be rehabilitated to the point where they can become a functional part of our society. Deinstitutionalization has led to the closing down and reduction of mental institutions, which means the thousands of patients who relied on these mental institutions have now been thrown out into society on their own without any support system to help them treat their mental illness. Years after the beginning of deinstitutionalization and after observing the numerous effects of deinstitutionalization it has become very obvious as to why our nation needs to be re-institutionalized.
Since it has become more understood better treatment plans have been created. There a various therapies and medications that can help manage mental health. However, there is an estimated 50 million people in America that has a mental disorder(s) and sadly only about 10 million will receive mental healthcare. Why is this? This happens simply because mental illness does not care who you are and how much money you do or do not have in the bank. Mental illnesses can effect anyone and it can be anyone of the numerous different psychological disorders. When mental illness effects a person it disrupts their whole life, this would include their daily living as well as effecting how preform at work. Take for instance, if they work a production job it can cause them not to make production. If they cannot function well enough to work at their required performance, then this could and probably would lead into them being fired from their job. Without a job they would not only lose their income but they would also have say bye-bye to their insurance plan as well. This would leave them without and mental healthcare. Did you know that if 50% of those with schizophrenia, 25% of those with anxiety disorders, 33% of those with depression are currently receiving successful treatment and the likely success rate will be around 80 to 90%? A number of people with
What is managed care? According to the Oxford English Dictionary, managed care is “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.” Managed care is a variety of techniques designed to reduce the cost of providing health benefits and advance the quality of care. In the United States alone, there are various managed care programs, that are ranged from more restrictive to less restrictive. As stated in the National Institutes of Health, the future of managed care is uncertain. It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed
Mental illness has been around as long as people have been. However, the movement really started in the 19th century during industrialization. The Western countries saw an immense increase in the number and size of insane asylums, during what was known as “the great confinement” or the “asylum era” (Torrey, Stieber, Ezekiel, Wolfe, Sharfstein, Noble, Flynn Criminalizing the Seriously Mentally Ill). Laws were starting to be made to pressure authorities to face the people who were deemed insane by family members and hospital administrators. Because of the overpopulation in the institutions, treatment became more impersonal and had a complex mix of mental and social-economic problems. During this time the term “psychiatry” was identified as the medical specialty for the people who had the job as asylum superintendents. These superintendents assumed managerial roles in asylums for people who were considered “alienated” from society; people with less serious conditions wer...
Mental healthcare has a long and murky past in the United States. In the early 1900s, patients could live in institutions for many years. The treatments and conditions were, at times, inhumane. Legislation in the 1980s and 1990s created programs to protect this vulnerable population from abuse and discrimination. In the last 20 years, mental health advocacy groups and legislators have made gains in bringing attention to the disparity between physical and mental health programs. However, diagnosis and treatment of mental illnesses continues to be less than optimal. Mental health disparities continue to exist in all areas of the world.
Braun, S. A., & Cox, J. A. (2005). Managed mental health care: Intentional misdiagnosis of
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.
The public’s views on mental illness. Paper presented at the annual meeting of the National Association for Mental Health. Swindle,R.,Heller,K.,& Pescosolido,B.(1997,August). Responses to “nervous breakdowns” in America over a 40-year period: Mental health policy implications. Paper presented at the meeting of the American Sociological Association, Toronto, Ontario.
If the United States had unlimited funds, the appropriate response to such a high number of mentally ill Americans should naturally be to provide universal coverage that doesn’t discriminate between healthcare and mental healthcare. The United States doesn’t have unlimited funds to provide universal healthcare at this point, but the country does have the ability to stop coverage discrimination. A quarter of the 15.7 million Americans who received mental health care listed themselves as the main payer for the services, according to one survey that looked at those services from 2005 to 2009. 3 Separate research from the same agency found 45 percent of those not receiving mental health care listing cost as a barrier.3 President Obama and the advisors who helped construct The Affordable Care Act recognized the problem that confronts the mentally ill. Mental healthcare had to be more affordable and different measures had to be taken to help patients recover. Although The Affordable Care Act doesn’t provide mentally ill patients will universal coverage, the act has made substantial changes to the options available to them.
In today’s society, the stigma around mental health has caused many people to fear seeking medical treatment for problems they are dealing with. With an abundance of hateful outlooks and stereotypical labels such as: crazy, psycho, and dangerous, it is clear that people with a mental illness have a genuine reason to avoid pursuing medical treatments. Along with mental health stigma, psychiatric facilities that patients with a mental health issue attend in order to receive treatment obtain an excessive amount of unfavorable stereotypes.
In the case of changing the mental health policy in North Carolina, the impetus for the change seems to be adopted by the State Auditor’s report beside other reports of many entities confirming the deviation of mental health service away from its original goal. According to these reports, mental health services are still delivered via traditional health delivery models rather than coordinated well-managed ones. Interestingly, these reports analyze the spectrum of mental health services nationwide with the exception of the State Auditor’s 2000 report Study of the Psychiatric Hospitals and the Area Mental Health Programs which was specifically designed for the North Carolina.
Continuing budget cuts on mental health care create negative and detrimental impacts on society due to increased improper care for mentally ill, public violence, and overcrowding in jails and emergency rooms. Origins, of mental health as people know it today, began in 1908. The movement initiated was known as “mental hygiene”, which was defined as referring to all things preserving mental health, including maintaining harmonious relation with others, and to participate in constructive changes in one’s social and physical environment (Bertolote 1). As a result of the current spending cuts approaching mental health care, proper treatment has declined drastically. The expanse of improper care to mentally ill peoples has elevated harmful threats of heightened public violence to society.
In 2010, the President Obama announced that the Affordable Care Act would extend its coverage to preventative mental health care coverage. This coverage would include depression screenings for adults and behavioral screenings for children and adolescents. In addition to this the President announced that the 2014 federal budget would include $130 million dedicated to aiding teachers in identifying the signs and risk factors of mental illness in their students, and r...
This affecting patient’s care, satisfaction, cost containment, and reimbursement strategies. Kippist, L., Fitzgerald, A., (2012), article discussing doctors role in hospitals in Australia is applicable to the outpatient psychiatric settings. They see this role as vital in achieving health reforms at the strategic and operational levels. They feel that since physician have power over a shrinking resource base, they are able to argue from an authoritative and, at times, evidence based position about the allotment of resources. They see physicians’ input into the development and prioritization of health service strategies as one of the most important advantages of the doctors’