QUALITY OF CARE AND COST-CONTAINMENT IN MANAGED MENTAL-HEALTH - POLICY, EDUCATION, RESEARCH, ADVOCACY

Managed mental health care cost-containment practices of risk-benefit analysis, provider usage, manipulation of supply and demand, gate keep ing, medical necessity, and formulation have adversely affected qualit y of care. Improved mental health services are dependent upon redefini ng mental health problems and understanding inequities created by medi calization as means to limit access to services. This dilemma can be a ddressed by development of mental health policy, public education, and political advocacy. An immediate role for professional psychology is found in the creation of a research agenda that documents empirically supported interventions for specific mental health problems, mechanism s of effective and acceptable service-delivery, and identification of providers with demonstrated clinical skills, including cultural compet encies.