Clinician experiences of managed mental health care: A rereading of the threat

The threat mental health professionals perceive in managed care, as indicat ed by their writings on the subject, is re-examined in light of evidence fr om an ethnographic study. Fieldwork focusing on clinician experiences of ma naged care was carried out at an urban community mental health center. Exis ting explanations of "the threat"-the possibility of deprofessionalization and the potential for deterioration in the quality of care proved inadequat e to account for the power it wielded at this site, perhaps because its ful l impact had yet to be felt at the time of data collection. A "rereading" s uggests the meaning of managed care for this group of clinicians lies in th e prospect of being gradually, unknowingly, and unwillingly reprofessionali zed from critics into proponents simply by virtue of continuing to practice in a managed care context, and in losing a moral vision of good mental hea lth treatment in the process.