Mental health services of the future: Managed care, unmanaged care, mismanaged care

Abstract

Rising costs. Treatable disorders. No treatment for many. High indirect expenses. The response to this contemporary set of circumstances has been managed mental health care. The transition from fee‐for‐service to managed behavioral health services has meant the industrialization of mental health care, an entirely new culture for providers, and a melding of the traditional public and private sectors. This article examines the evolution of managed behavioral healthcare from the point of view of how and why it occurred, what it means for providers, how it will impact on the seriously mentally ill, ways in which pay ors and providers can reach consensus on future directions, and the risks inherent in this process.