Annotated Bibliography - Community Mental Health Services

This special supplementary section of the bibliography provides an independently produced annotated bibliography on managed behavioural healthcare prepared for the US Substance Abuse and Mental Health Services Administration; please see the first page of the supplement for recommended citation information.

Table of Contents

  1. Introduction
  2. Benefit and System Design
  3. Capitation
  4. Community Mental Health Services
  5. Diagnosis-Related Groups (DRGs)
  6. Economics, Forecasting, and Pricing
  7. Employee Assistance Programs (EAPs)
  8. Health Maintenance Organizations (HMOs)
  9. Law and Ethics
  10. Provider Issues
  11. Public Sector
  12. Quality Assurance and Outcomes
  13. Special Populations
    1. Children
    2. Elderly
    3. Ethnic Groups
    4. Women
  14. Substance Abuse
  15. Training and Education
  16. Utilization Management
  17. Author Index
  18. Keyword Index

Community Mental Health Services

107. Christianson, J. B., Lurie, N., Finch, M., Moscovice, I. S., & Hartley, D. (1992). Use of community-based mental health programs by HMOs: Evidence from a Medicaid demonstration. American Journal of Public Health, 82, 790-796.

This article tests the hypothesis that Medicaid beneficiaries in HMOs reduce their use of mental health treatment programs in their communities, thereby jeopardizing the financial viability of these programs. A randomized trial of two groups of severely mentally ill Medicaid beneficiaries (one with traditional Medicaid benefits and one with HMO benefits) showed no significant short-term difference in the use of community-based programs. The authors suggest that Medicaid program administrators can minimize the disruption of on-going treatment for beneficiaries who join prepaid groups by offering beneficiaries a choice among prepaid plans and encouraging community treatment programs to contract with plans to serve beneficiaries.
Keywords:community providers, evaluation, HMOs, Medicaid, serious mental illness

108. Cypres, A., Landsberg, G., & Spellman, M. (1997). The impact of managed care on community mental health outpatient services in New York State. Administration and Policy in Mental Health, 24(6), 509-521.

This article explores the impact of managed care on community mental health centers. It reports the results of a survey that was administered to the directors of all licensed outpatient mental health facilities (clinics, day treatment, and intensive outpatient psychiatric rehabilita-tion) in New York State. Indeed, these facilities reported extensive changes in the past as well as predicted changes in the future as a result of the impact of managed care. These changes occurred in a variety of areas Ñ staffing patterns, rate at which various services are offered, revenue sources, joining managed care panels, advertising, and training Ñ and differed depending upon size, region, and type of facility. The survey also inquired into respondents’ experiences with and attitudes toward managed care. The study reports that directors predict declines in the number of staff other than psychiatrists (psychologists in particular), that they document a shift away from open-ended treatment and toward more acute and short-term care, and that they have a variety of concerns and frustrations arising from their experiences with managed care.
Keywords:community providers, New York

109. Feldman, S. (1994). Managed mental health Ñ Community mental health revisited? Managed Care Quarterly, 2(2), 13-18.

The author argues that despite the superficial differences between the community mental health movement of the 1960s and the current managed care movement, there may be a greater commonality in processes, values, and objectives between them than is readily appar-ent. Both focus on alternatives to hospitalization; both appear to have in common a belief in the value of continuity of care, the responsibility for a defined population, and recognition of the importance of easy access and early intervention. Because of these similarities, lessons from community mental health may be applicable to managed care, and, in particular, the impor-tance of an academic base for training and research and the potentially negative impact of oversell and inflated expectations.
Keywords:community providers

110. Ray, C., & Oss, M. (1993). Community mental health and managed care. New Directions for Mental Health Services, 59, 89-98.

Community mental health centers (CMHCs) face a number of challenges if they are to func-tion effectively in an era of managed care. The authors argue that CMHCs must balance their social mission to provide mental health care to high-risk populations with a new sophistication about finance, marketing, and operating in a managed environment. Using examples from the experiences of Massachusetts CMHCs, the authors lay out options for CMHCs in their attempt to survive in this new environment. The article concludes with a discussion of the opportunities for CMHCs to be major participants in the movement toward managed mental health care.
Keywords:community providers

111. Young, A. S., Sullivan, G., Murata, D., Sturm, R., & Koegel, P. (1998). Implementing publicly funded risk contracts with community mental health organizations. Psychiatric Services, 49(12), 1579-1584.

This article presents a case study of the Los Angeles County Partners Program, a contractual arrangement for services for severely mentally ill individuals between Los Angeles County Department of Mental Health and community mental health organizations. By providing a fixed annual rate per enrolled patient, the program shifted the financial risk for treatment to community organizations. From both qualitative and quantitative data, the researchers found that the new approach geared toward the most expensive patients enhanced programs’ flexibil-ity and accountability and increased their emphasis on principles of psychosocial rehabilitation. The article discusses challenges in implementation including disenrollment, limitations with existing information systems, and changes necessitated by risk contracting in general. They conclude that although mental health authorities planning to institute risk contracts need to balance fiscal incentives with performance guarantees, risk contracting offers great opportunity to improve service delivery.
Keywords:California, capitation, community providers, local governments, public sector, serious mental illness

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This page was last reviewed by Dr Greg Mulhauser, Thursday, 14 October 2021.