Understanding how mental illness cases are managed for insured populations by large managed behavioral health organizations, and comparing the quality of care in large health care systems are the focus of two articles in the May issue of the Psychiatric Services Journal.
Managed behavioral health organizations are now responsible for providing mental health benefits to the majority of privately insured Americans, and have significantly reduced the costs compared with indemnity insurance and HMOs. In a study from the University of California, Davis, researchers examined the process of utilization management and found that after 9,639 reviews, less than 10 percent of treatment services were denied, or were approved at a level lower than requested by the provider.
A study from Connecticut-Massachusetts VA Mental Illness Research, Education, and Clinical Center measured the quality of mental health care of VA hospitals with privately insured patients. Researchers found that although the private sector modestly outperformed the VA on most quality measures, the VA treats a more troubled population, and the VA improved over time compared with the private sector.
1. ["Utilization Management in a Large Managed Behavioral Health Care Organization," by Alan Koike, et. al., pp. 621-626] APAfastFAX#6936 2. ["Comparing Quality of Mental Health Care for Public-Sector and Privately Insured Populations," by Douglas L. Leslie, et. al., pp. 650-655] APAfastFAX#6937
Also in this issue of Psychiatric Services Journal:
Police on Front Line in Mental Health Emergencies
Because police play a critical role in mental health emergencies, communities nationwide have introduced special training and practices to help ensure that people experiencing a mental health crisis are diverted from jails to treatment settings. In a study affiliated with Policy Research Associates in New York, researchers compared programs in three U.S. cities--Memphis, Birmingham and Knoxville.
Large differences were found in the proportion of calls that resulted in a specialized response--a response involving specially trained mental health personnel. Memphis fared the best because of crisis drop-off center for persons with mental illnesses that has a no-refusal policy for police cases. All three cities had relatively low arrest rates when a specialized response was made, making collaboration between the criminal justice system and the mental health system critical.
["Comparing Outcomes of Major Models of Police Responses to Mental Health Emergencies," by Henry J. Steadman, et. al., pp. 645-649]APAfastFAX#6938
Copies of these articles are available in their entirety by calling APAfastFAX at 888-357-7924.
The American Psychiatric Association is a national medical specialty society, founded in 1844, whose nearly 40,000 physician members specialize in the diagnosis, treatment and prevention of mental illnesses and substance use disorders.
Erin Murphy
202-682-6324
emurphy@psych.org
Fax: 202-682-6255
Journal
Psychiatric Services