SHAPING NATIONAL POLICY - DELEGATION AND DECENTRALIZATION OF MENTAL-HEALTH-CARE

Over the past 2 decades there has been a trend among industrialized na tions of delegating responsibility for the delivery and financing of m ental health care to lower levels of government, private organizations , or both. This trend reflects several hopes, for example, that the or ganizations assuming responsibility will bring greater expertise to th is task, will be more efficient, and less costly. However, the trend a lso raises a number of concerns, such as fears of undertreatment and o f poor quality of care. In delegating this responsibility, payers for mental health care must carefully consider how to structure incentives for those organizations assuming the responsibility in order to ensur e adequate access to high quality services.