Managed mental health care for seriously mentally ill populations

Privatization of health care and the diminishing role of the 'state' in the public's health are the most pressing issues in behavioral health care ref orm today. This review provides a brief summary of the US experience with m anaged mental health care in privately insured populations, followed by exp eriences with public sector populations via 'demonstration programs', and m ore recent findings from statewide demonstration programs including larger numbers of public sector clients. In addition, a description of European re forms that equate to 'managed care' is given. The paper addresses the quest ion of whether managed care strategies, used to effect reductions in use an d cost of mental health care in the 'privately' insured US population, can be duplicated without adverse consequences in 'public sector' populations. Curr Opin Psychiatry 12:211-216. (C) 1999 Lippincott Williams & Wilkins.