Skip to main content

Advertisement

SpringerLink
Log in

The Effects of Federal Versus State Funding and Academic Affiliation on Mental Health Services

  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

This study compares mental health services in three facilities on two domains: federal versus state funding and academic affiliation. Data from a cross-sectional study of psychiatric outpatients is utilized to compare 196 VA patients to 337 non-VA patients treated in two state mental health agencies. The strength of academic affiliation of the facilities and the degree of participation in research and training activities differs significantly across facilities but is not associated with quality of care, clinical outcomes, or satisfaction with care. Compliance with schizophrenia PORT treatment recommendations is low but similar across sites. These findings suggest that, unlike findings from the general medical literature, academic affiliation is unrelated to the quality and delivery of mental health care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • J.J. Allison C.I. Kiefe N.W. Weissman S.D. Person M. Rousculp J.G. Canto S. Bae O.D. Williams R. Farmer R.M. Centor (2000) ArticleTitleRelationship of hospital teaching status with quality of care and mortality for Medicare patients with acute MI JAMA 284 1256–1262 Occurrence Handle10.1001/jama.284.10.1256 Occurrence Handle1:STN:280:DC%2BD3cvjvVGqsQ%3D%3D Occurrence Handle10979112

    Article  CAS  PubMed  Google Scholar 

  • J.Z. Ayanian J.S. Weissman S. Chasan-Taber A.M. Epstein (1998) ArticleTitleQuality of care for two common illnesses in teaching and nonteaching hospitals Health Affairs 17 194–205 Occurrence Handle10.1377/hlthaff.17.6.194 Occurrence Handle1:STN:280:DyaK1M7hsVCjsg%3D%3D Occurrence Handle9916369

    Article  CAS  PubMed  Google Scholar 

  • J.D. Bray J.J. Bevilacqua (1993) ArticleTitleA multidisciplinary public-academic liaison to improve public mental health services in South Carolina Hosp Community Psychiatry 44 985–990 Occurrence Handle1:STN:280:DyaK2c%2FktFaltA%3D%3D Occurrence Handle8225282

    CAS  PubMed  Google Scholar 

  • M. A. Burnman J. J. Escarce (1999) ArticleTitleEquity in managed care for mental disorders Health Affairs 18 22–31 Occurrence Handle10.1377/hlthaff.18.5.22

    Article  Google Scholar 

  • P.D. Cleary S. Edgman-Levitan M. Roberts T.W. Moloney W. McMullen J.D. Walker T.L. Delbanco (1991) ArticleTitlePatients evaluate their hospital care: A national survey Health Affairs 10 254–267 Occurrence Handle10.1377/hlthaff.10.4.254 Occurrence Handle1:STN:280:DyaK387jslygtQ%3D%3D Occurrence Handle1778560

    Article  CAS  PubMed  Google Scholar 

  • D.J. Dausey R.A. Rosenheck A.F. Lehman (2002) ArticleTitlePreadmission care as a new mental health performance indicator Psychiatric Services 53 1451–1455 Occurrence Handle10.1176/appi.ps.53.11.1451 Occurrence Handle12407274

    Article  PubMed  Google Scholar 

  • B. Dickey E. Norton S.L. Norman H. Azeni W.H. Fisher (1998) Managed mental health experience in Massachussetts Mechanic D. (Eds) Managed behavioral health care: Current realities and future potential Jossey-Bass San Francisco:

    Google Scholar 

  • L.R. Faulkner J.S. Eaton R.M. Rankin (1983) ArticleTitleAdministrative relationships between state hospitals and academic psychiatry departments American Journal of Psychiatry 140 898–901 Occurrence Handle1:STN:280:DyaL3s3ivVGlsQ%3D%3D Occurrence Handle6859309

    CAS  PubMed  Google Scholar 

  • L.L. Hall E.R. Edgar L. M. Flynn (1997) Stand and deliver: Action call to a failing industry National Alliance for the Mentally Ill Washington, DC

    Google Scholar 

  • M.A. Hanson E.L. Stone W.E. Penk R.B. Flannery SuffixJr S.M. Goldfinger (1998) ArticleTitlePublic- academic liaison research centers in an era of managed care The Psychiatric Quarterly 69 61–68 Occurrence Handle10.1023/A:1022185407636 Occurrence Handle1:STN:280:DyaK1c7pslGguw%3D%3D Occurrence Handle9536475

    Article  CAS  PubMed  Google Scholar 

  • Health Plan Employer Data and Information SetVersion 3.0. (1998). Washington, DC: National Committee on Quality Assurance.

  • E.B. Keeler L.V. Rubenstein K.L. Kahn D. Draper E.R. Harrison M.J. McGinty W.H. Rogers R.H. Brook (1992) ArticleTitleHospital characteristics and quality of care JAMA 268 1709–1714 Occurrence Handle10.1001/jama.268.13.1709 Occurrence Handle1:STN:280:DyaK38vgvVSmtg%3D%3D Occurrence Handle1527880

    Article  CAS  PubMed  Google Scholar 

  • A.F. Lehman D.M. Steinwachs (1998a) ArticleTitleTranslating research into practice: The schizophrenia Patients Outcomes Research Team (PORT) treatment recommendations Schizophr Bull 24 1–10 Occurrence Handle1:STN:280:DyaK1c7mtFKnug%3D%3D

    CAS  Google Scholar 

  • A.F. Lehman D.M. Steinwachs (1998b) ArticleTitlePatterns of usual care for schizophrenia: Nitial results from the schizophrenia patients outcomes research team (PORT) client survey Schizophr Bull 24 11–20 Occurrence Handle1:STN:280:DyaK1c7mtFKnuw%3D%3D

    CAS  Google Scholar 

  • D.L. Leslie R.A. Rosenheck (1999) ArticleTitleShifting to outpatient care? Mental health utilization and costs in a privately insured population American Journal of Psychiatry 156 1250–1257 Occurrence Handle1:STN:280:DyaK1MznvVOlsA%3D%3D Occurrence Handle10450268

    CAS  PubMed  Google Scholar 

  • D.L. Leslie R.A. Rosenheck (2001) ArticleTitleThe quality of pharmacotherapy for schizophrenia in a national health care system: Individual and facility predictors Medical Care 39 923–933 Occurrence Handle10.1097/00005650-200109000-00003 Occurrence Handle1:STN:280:DC%2BD3MvlslWhtQ%3D%3D Occurrence Handle11502950

    Article  CAS  PubMed  Google Scholar 

  • A.T. McLellan J. Cacciola H. Kushner R. Peters I. Smith H. Pettinati (1992) ArticleTitleThe fifth edition of the addiction severity index: Cautions, additions, and normative data Journal of Substance Abuse Treatment 9 461–480 Occurrence Handle10.1016/0740-5472(92)90062-S

    Article  Google Scholar 

  • J.E. Overall D.R. Gorham (1962) ArticleTitleThe brief psychiatric rating scale Psychological Reports 10 799–812 Occurrence Handle10.2466/PR0.10.3.799-812

    Article  Google Scholar 

  • M.K. Popkin N. Lurie W. Manning J. Harman A. Callies D. Gray J. Christianson (1998) ArticleTitleChanges in process of care for Medicaid patients with schizophrenia in Utah’s prepaid mental health plan Psychiatric Services 49 518–523 Occurrence Handle1:STN:280:DyaK1c3gvFKitg%3D%3D Occurrence Handle9550244

    CAS  PubMed  Google Scholar 

  • A. Rosen J. Wu B.H. Chang D. Berlowitz C. Rakovski A. Ash M. Moskowitz (2001) ArticleTitleRisk adjustment for measuring health outcomes: An application in VA long-term care American Journal of Medical Quality 16 118–127 Occurrence Handle1:STN:280:DC%2BD3MvjtVGjsA%3D%3D Occurrence Handle11477956

    CAS  PubMed  Google Scholar 

  • R.A. Rosenheck D. Cicchetti (1998) ArticleTitleA mental health program report card: A multidimensional approach to performance monitoring in public sector programs Community Mental Health Journal 34 85–106 Occurrence Handle10.1023/A:1018720414126 Occurrence Handle1:STN:280:DyaK1c3hvF2qtA%3D%3D Occurrence Handle9559242

    Article  CAS  PubMed  Google Scholar 

  • R.A. Rosenheck R. Desai D. Steinwachs A. Lehman (2000) ArticleTitleBenchmarking treatment of schizophrenia: A comparison of service delivery by the national government and by state and local providers The Journal of Nervous and Mental Disease 188 209–216 Occurrence Handle10.1097/00005053-200004000-00003 Occurrence Handle1:STN:280:DC%2BD3c3kvV2jug%3D%3D Occurrence Handle10789997

    Article  CAS  PubMed  Google Scholar 

  • R.A. Rosenheck D. Dilella (1999) National Mental Health Program Performance Monitoring System: Fiscal year 1998 report Northeast Program Evaluation Center West Haven, CT

    Google Scholar 

  • R. Rosenheck T. Horvath (1998) ArticleTitleThe impact of VA reorganization on patterns of mental health care Psychiatric Service 49 53 Occurrence Handle1:STN:280:DyaK1c7gslSrtw%3D%3D

    CAS  Google Scholar 

  • G.E. Rosenthal D.L. Harper L.M. Quinn G.S. Cooper (1997) ArticleTitleSeverity-adjusted mortality and length of stay in teaching and non-teaching hospitals: Results of a regional study JAMA 278 485–490 Occurrence Handle10.1001/jama.278.6.485 Occurrence Handle1:STN:280:DyaK2szpvVehtw%3D%3D Occurrence Handle9256223

    Article  CAS  PubMed  Google Scholar 

  • A.B. Santos J. C. Ballenger J.J. Bevilacqua J.J. Zealberg T.G. Hiers S. McLeod-Bryant P. A. Deci L. J. Rames (1994) ArticleTitleA community-based public-academic liaison program American Journal of Psychiatry 151 1181–1187 Occurrence Handle1:STN:280:DyaK2czhtFeltg%3D%3D Occurrence Handle8037253

    CAS  PubMed  Google Scholar 

  • M.J. Sernyak D. Dausey R. Desai R. Rosenheck (2003) ArticleTitlePrescriber non-adherence to treatment guidelines despite a self-assessed need for neuroleptic change Psychiatric Service 54 246–248 Occurrence Handle10.1176/appi.ps.54.2.246

    Article  Google Scholar 

  • D.H. Taylor SuffixJr D.J. Whellan F.A. Sloan (1999) ArticleTitleEffects of admission on a teaching hospital on the cost and quality of care for Medicare beneficiaries The New England Journal of Medicine 340 293–299 Occurrence Handle10.1056/NEJM199901283400408 Occurrence Handle9920955

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Northeast Program Evaluation Center, Yale University School of Medicine, USA

    Rani A. Desai

  2. RAND, Pittsburg

    David J. Dausey

  3. VA Connecticut Healthcare System, Yale University School of Medicine, USA

    Michael Sernyak

  4. Northeast Program Evaluation Center, Yale University School of Medicine, USA

    Robert A. Rosenheck

  5. VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, USA, 06516

    Rani A. Desai

Authors
  1. Rani A. Desai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David J. Dausey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Sernyak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert A. Rosenheck
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rani A. Desai.

Additional information

This study was supported by VA HSR & D grant #PR94-002. The authors would like to thank the clinical managers at each of the non-VA sites for their help in collecting and interpreting the data, including Jeanne Steiner, D.O. (Connecticut Mental Health Center), and Stephen Atkins, M.D. (Greater Bridgeport Mental Health Center).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Desai, R.A., Dausey, D.J., Sernyak, M. et al. The Effects of Federal Versus State Funding and Academic Affiliation on Mental Health Services. Adm Policy Ment Health 32, 267–283 (2005). https://doi.org/10.1007/s10488-004-0844-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-004-0844-3

Keywords

Search

Navigation