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A prospective management approach to the delivery of public mental health services

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

Abstract

This paper identifies the principal components of a prospective strategy for management of public mental health systems: single stream funding and prepayment, prevention and promotion programs for the at-risk population, decision support systems to identify at risk populations and interventions such as managed care of high-risk clients and the most severe and persistently mentally ill. Pertinent literature and major studies are briefly reviewed.

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References

  • Aiken, L.H., Somers, S.A., & Shore, M.F. (1986). Private foundations in health affairs: A case study of the development of a national initiative for the chronically mentally ill.American Psychologist, 41, 1290–1295.

    Google Scholar 

  • Bachrach, L.L. (1987). Consensus and issues: Report on a conference to define the chronically mentally ill. Unpublished document, National Institute of Mental Health, Rockville, MD.

    Google Scholar 

  • Bassuk, E.L., & Gerson, S. (1980). Chronic crisis patients: A discreet clinical group. American Journal of Psychiatry,137, 1513–1517.

    Google Scholar 

  • Bloom, B.L., Hodges, W.F., Kern, M.B., & McFaddin, S.C. (1985). A preventive intervention program for the newly separated.American Journal of Orthopsychiatry, 55, 9–26.

    Google Scholar 

  • Bloom, B.L., Hodges, W.F. & Caldwell, N.A. (1982). A prevention program for the newly separated: Initial evaluation.American Journal of Community Psychology, 10, 257–264.

    Google Scholar 

  • Brenner, M.H. (1973).Mental illness and the economy. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Brown, P. (1985).Mental health care and special policy. Boston: Routledge and Kagen Paul.

    Google Scholar 

  • Burt, M.R., & Pittman, K.J. (1986).Testing the social safety net. Urban Institute.

  • Caplan, G. (1980).Principles of preventive psychiatry. New York: Basic Books.

    Google Scholar 

  • Davidson, A.T. (1977). Child abuse: Causes and prevention.Journal of the National Medical Association, 69, 817–820.

    Google Scholar 

  • Dorwart, R.A., & Schlesinger, M. (1988). Privatization of psychiatric services.American Journal of Psychiatry, 145, 543–553.

    Google Scholar 

  • Dorwart, R.A., Schlesinger, M., Horgan, C. & Davidson, H. (1989). The privatization of mental health care and direction for mental health services research. In C.A. Taube, D. Mechanic & A. Hohmann (Eds.),The future of mental health services research (DHHS Pub. No. ADM 89-1600). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Federal Register, Volume 50, No. 167. August 20, 1985, Rules and Regulations.

  • Frank, R.G. (1985). Pricing and location of physician services in mental health.Economic Inquiry, 23, 1115–133.

    Google Scholar 

  • Frank, R.G. (1988). Use of mental health services and persistence of emotional distress: An exploratory analysis.Medical Care, 26(12).

  • Frank, R.G., & Lave, J.R. (1986). Per case prospective payment for psychiatric inpatients: An assessment and alternatives.Journal of Health Politics, Policy, and Law, 11(1).

  • Frank, R.G., & McGuire, T.G. (1986). A review of studies of the impact of insurance on the demand and utilization of specialty mental health services.Health Services Research, 21, Part II, 241–266.

    Google Scholar 

  • Goldman, H.H., Taube, C., & Regier, D. (1984). Prospective payment for psychiatric hospitalization: Questions and issues.Hospital and Community Psychiatry, 35(5).

  • Goldman, H., & Taube, C. (1988). High users of outpatient mental health services, II: Implications for practice and policy.American Journal of Psychiatry, 145(1).

  • Goldstein, J.M., & Horgan, C.M. (1988). Inpatient and outpatient psychiatric services: substitutes or complements?Hospital and Community Psychiatry, 39, 632–636.

    Google Scholar 

  • Greenley, J.R., & Mechanic, D. (1976). Social selection in seeking help for psychological problems.Journal of Health and Social Behavior, 17, 249–262.

    Google Scholar 

  • Greer, S.A. (1962).The emerging city: Myth and reality. New York: Free Press of Glencoe.

    Google Scholar 

  • Gruenberg, E. (1980). Mental disorders. In J. M. Last (Ed.),Public health and preventive medicine. New York: Appleton-Century-Crofts.

    Google Scholar 

  • Hadley, T.R., Schinnar, A.P., Rothbard, A.B., & Kinosian, M.S. (1989). Capitation financing of public mental health services for the chronically mentally ill.Administration and Policy in Mental Health, 16, 201–213.

    Google Scholar 

  • Hargreaves, W.A., Attkinson, C.C., Siegal, L.M., McIntyre, M., & Sorensen, J.F. (1974) (Eds.).Resource materials for community mental health programs evaluation, Part III: Needs assessment and planning. Rockville, MD: NIMH.

    Google Scholar 

  • Horgan, C. (1985). Specialty and general ambulatory mental health services: Comparison of utilization and expenditures.Archives of General Psychiatry, 42, 565–572.

    Google Scholar 

  • Kamis-Gould, E. (1983).Policy and planning values of the MHDPS: A state mental health system perspective. Trenton, NJ: Division of Mental Health and Hospitals.

    Google Scholar 

  • Keeler, E., Wells, K., Manning, W., Rumpel, D., & Hanley, J. (1986, October).The demand for episodes of mental health services. RAND R-3432-NIMH.

  • Kramer, M. (1977).Psychiatric services and the changing institutional scene (DHEW Pub. No. ADM 77-433). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Kramer, M. The rising pandemic of mental disorders and associated chronic diseases and disabilities. Acta Psychiatrica Scandinavica62. (Suppl. 285).

  • Manning, W.G., Wells, K., Duan, N., Newhouse, J., & Ware, J. (1986). How cost sharing affects the use of ambulatorymental health services.Journal of the American Medical Association, 256(14).

  • McGuire, T.G. (1981).Financing psychotherapy: Costs, effects, and public policy. Cambridge, MA: Ballinger Publishing Company.

    Google Scholar 

  • McGuire, T.G., & Dickey, B. (1986). Prospective payment for mental health care: Economics issues. Research paper supported by Pew Charitable Trusts: 1–22.

  • Miller, G., Dear, M., & Streiner, D. (1986). A model for predicting utilization of psychiatric facilities.Canadian Journal of Psychiatry, 31, June.

  • New York State Office of Mental Health (1988, December). ICM intensive case management: A brief public report.

  • Olds, D.L., Henderson, C.R., & Tatelbaum, R. (1986). Preventing child abuse and neglect: A randomized trial of nurse home visitation.Pediatrics, 78, 65–78.

    Google Scholar 

  • Pharis, D.B. (1976). The use of needs assessment techniques in mental health planning.American Mental Health Review, 1 (4), 4–11.

    Google Scholar 

  • Price, R.H., Cowen, E.L., Lorion, R.P., & Ramos-McKay, J. (1989) The search for effective prevention programs: What we learned along the way.American Journal of Orthopsychiatry, 59, 49–58.

    Google Scholar 

  • Redich, R.W., et al. (1977). 1970 census data used to indicate areas with different patterns for mental health and related problems (DHEW Publication No. ADM 75-159, Methodology Reports, Mental Health Statistics, Series C, No. 3). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Department of Health and Human Services. (1962, December). Report to Congress: Hospital prospective payment for Medicare. Washington, DC: Author.

    Google Scholar 

  • Robins, L., Helzer, J.E., Weissman, M.M., Orvaschel, E., Gruenberg, Burke, Jr., J.D., & Regier, D.A. (1984). Lifetime prevalence of specific psychiatric disorders in three sites.Archives of General Psychiatry, 41, 949–958.

    Google Scholar 

  • Rosen, B.M., Lawrence, L., Goldsmith, Shambaugh, J.P., & Windle, C.D. (1975).Mental health demographic profile description:Purpose contents, and sampler of uses (DHEW Publication No. ADM 76-263). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Rosen, B.M., & Goldsmith, H.F. (1981). The health demographic profile system: Current and longitudinal data base for social area analysis.Evaluation and Program Planning 4, 57–73.

    Google Scholar 

  • Rothbard, A.B., Hadley, T.R., Schinnar, A.P., Morgan, D., & Whitehill, B. (1989). Philadelphia's capitation plan for mental health services.Hospital and Community Psychiatry, 40, 356–358.

    Google Scholar 

  • Rothbard, A.B., Schinnar, A.P., Hadley, T.R., & Rovi, J.I. (1989, September).Integration of mental health data on hospital and community services (ADMH 18(2), 91–99. Nov. 1990).

    Google Scholar 

  • Schinnar, A.P., & Rothbard, A.B. (1989, September),Communitywelfare and allocation of mental health care management resources (Wharton PMW Report No. 8906). Philadelphia, PA: Univ. of Pennsylvania.

    Google Scholar 

  • Schinnar, A.P., Rothbard, A.B. (1989). Evaluation questions for Philadelphia's mental health capitation experiment.Hospital and Community Psychiatry, 40, 681–683.

    Google Scholar 

  • Schinnar, A.P., & Rothbard, A.B.High-risk clients and mental health care management (Socio-Economic Planning Sciences, in press Feb. 1992).

  • Schinnar, A.P., Rothbard, A.B., & Kanter, R. (1989, May).Is there a social safety net for the severe and persistently mentally ill? (Wharton PMW Report No. 8901). Philadelphia, PA: Univ. of Pennsylvania.

    Google Scholar 

  • Schinnar, A.P., Rothbard, A.B., & Hadley, T.R. (1989). Opportunities and risks in Philadelphia's capitation financing of public psychiatric services.Community Mental Health Journal, 25, 255–266.

    Google Scholar 

  • Schinnar, A.P., Rothbard, A.B. & Hadley, T.R. (1989, October).Predictions of psychiatric hospitalization and prospective case management (Wharton PMW Report No. 8912). Philadelphia, PA: Univ. of Pennsylvania.

    Google Scholar 

  • Schinnar, A.P., Rothbard, A.B., Rovi, J.I. & Hadley, T.R. (October 1990).Turnover and utilization patterns of Medicaid recipients of mental health care (Wharton PMW Report No. 900b). Philadelphia, PA: Univ. of Pennsylvania.

    Google Scholar 

  • Schinnar, A.P., Rothbard, A.B., & Hadley, T.R.. Community determinants of psychiatric hospitalization and length of stay. Wharton PMW Report No. 8808 June 1989. Philadelphia, PA: Univ. of Pennsylvania.

    Google Scholar 

  • Schlesinger, M.R., Dorwart, R., & Pulice, R. (1986). Competitive bidding and states' purchase of services.Journal of Policy Analysis and Management, 5, 245–263.

    Google Scholar 

  • Shapiro, W., Skinner, E.A., Kessler, L.G., Vonkorff, M., Tischler, G.L., Leaf, A.J., Benham, L., Cottler, & Regier, D.A. (1984). Utilization of health and mental health services.Archives of General Psychiatry, 41, 959–970.

    Google Scholar 

  • Silverman, P. (1986).Widow to widow. New York: Springer.

    Google Scholar 

  • Surles, R.C., & McGurrin, M.C. (1986).Emergence of young chronically mentally ill in acute psychiatric services in an urban community. Philadelphia, PA: Office of Mental Health/Mental Retardation.

    Google Scholar 

  • Taube, C.L., Kessler, L., & Burns, B. (1986). Estimating the probability and level of ambulatory mental health services use.Health Services Research, 21, Part II.

  • Vachon, M.L.S., Lyall, W.A.L., Rogers, R.N., Freedman-Letofsky, K., & Freeman, S.J.J. (1980). A controlled study of self help intervention for widows.American Journal of Psychiatry, 137, 1380–1384.

    Google Scholar 

  • Warheit, G.J., Bell, R.A., & Schwab, J.J. (1977).National Institute of Mental Health needs assessment approaches: Concepts and methods (DHEW Publication No. ADM 77-472). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Watts, C., Scheffler, R. & Jewell, N. (1986). Demand for outpatient mental health services in a heavily insured population: The case of Blue Cross/Blue Shield federal employees health benefits program.Health Services Research, 21, 267–290.

    Google Scholar 

  • Wells, K.B., Manning, W.G., Duan, N., Newhouse, J.P., & Ware, J. (1986). Use of outpatient mental health services by a general population with health insurance.Hospital and Community Psychiatry, 37, 1119–1125.

    Google Scholar 

  • White, E.C. (1985, May 10). Centers refine their advertising as era of soft-peddling ends.Modern Health Care.

  • Widem, P., Pincus, H.A., Goldman, H.H., & Jencks, S. (1984). Prospective payment for psychiatric hospitalization: Context and background.Hospital and Community Psychiatry, 35, 447–451.

    Google Scholar 

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Authors and Affiliations

  1. Policy Modeling Workshop, The Wharton School, Univ. of Pennsylvania, 3814 Walnut St., 19104, Philadelphia, PA

    A. P. Schinnar Ph.D. & A. B. Rothbard Sc.D.

  2. Dept. of Psychiatry, Univ. of Pennsylvania, Philadelphia, USA

    A. P. Schinnar Ph.D., A. B. Rothbard Sc.D. & T. R. Hadley Ph.D.

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  1. A. P. Schinnar Ph.D.
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  2. A. B. Rothbard Sc.D.
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  3. T. R. Hadley Ph.D.
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Schinnar, A.P., Rothbard, A.B. & Hadley, T.R. A prospective management approach to the delivery of public mental health services. Adm Policy Ment Health 19, 291–308 (1992). https://doi.org/10.1007/BF00708321

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