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Rationing psychosocial treatments in the United States
University of Michigan.
University of Michigan.
University of Michigan.
2005 (English)In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 28, no 5, p. 545-560Article in journal (Refereed) Published
Abstract [en]

This paper briefly reviews the recent history of psychosocial treatment for adults with severe mental illnesses in the United States. It examines the current sources and financing of such care, revealing the planned and unplanned reclassification of entitled beneficiaries and eligible patients, appropriate treatment, acceptable outcomes, and levels and sources of payment. One illustration of this phenomenon is seen in current efforts to identify and deliver only those public services that are covered by Medicaid, so as to allocate state resources only when they can be matched by federal monies. Another is the reliance on private health insurance, tied in the U.S. almost exclusively to employment, for medical care delivered under an acute, rather than a chronic care model. These analyses conclude with a discussion of the implicit and explicit mechanisms used to ration access to psychosocial treatment in the United States. The implications for individuals with serious mental illnesses, their families, and the general public are placed in historical and current policy contexts, recognizing the economic, social, and clinical variables that can moderate outcomes. 

Place, publisher, year, edition, pages
Elsevier , 2005. Vol. 28, no 5, p. 545-560
Keywords [en]
neuroleptic agent, disease severity, employment, family, financial management, government, health care cost, health care delivery, health care policy, health economics, health insurance, human, managed care, medicaid, medical care, medicare, mental disease, mental health service, psychosocial care, resource allocation, review, social aspect, treatment outcome, United States
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-38566DOI: 10.1016/j.ijlp.2005.08.008Scopus ID: 2-s2.0-25144464535OAI: oai:DiVA.org:hig-38566DiVA, id: diva2:1659616
Available from: 2022-05-20 Created: 2022-05-20 Last updated: 2022-05-20Bibliographically approved

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Holter, Mark

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CiteExportLink to record
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Citation style
  • apa
  • harvard-cite-them-right
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • sv-SE
  • en-GB
  • en-US
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  • nn-NO
  • nn-NB
  • de-DE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf