Managed mental health care: Attitudes and ethical beliefs of child and pediatric psychologists

Objective: To examine child and pediatric psychologists' ethical beliefs an d attitudes toward managed mental health care. Methods: In a survey mailed in spring 1997, 252 child and pediatric psychol ogists responded to three vignettes depicting ethical dilemmas related to w orking with managed mental health care (confidentiality, restriction of ser vices, misdiagnosis). Data were collected about psychologists' ethical choi ces and reasons given for choices, attitudes toward managed care, the exten t to which managed care affected ethical decision making, and level of mana ged care involvement. Results: Differences were found in choices made for the ethical dilemmas in regard to what participants thought they should do, would do, and actually did do. Overall, participants endorsed negative attitudes toward managed c are. Participants reported that managed care somewhat affected their ethica l decision making for the vignettes. Level of managed care involvement was not related to ethical decision making or attitudes toward managed care. Conclusions: The findings suggest areas for examination as new ethical stan dards are created for work in managed care environments.