State Mental Health Policy: Critical Elements of Public-Sector Managed Behavioral Health Programs for Severe Mental Illness in Five States

The term “managed care” may be used to describe a wide variety of arrangements that have different structures, functions, and effects on the care of people who have behavioral health disorders. The evaluation of public-sector managed care plans has been hindered by a lack of a systematic vocabulary for describing them and a lack of instruments to operationalize this vocabulary into a set of measurement procedures. We developed and pilot tested an instrument to be used in categorizing public-sector managed care arrangements (1). The instrument was used to collect descriptive data on managed care plans in the Managed Behavioral Health Care in the Public Sector Study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA). In this multisite study, a competitive process was used to fund 21 sites in order to evaluate managed behavioral health services for four target populations. Here we report preliminary descriptive data from five SAMHSA sites at which the impact of managed care on adults with severe mental illness— one of the most vulnerable and important public-sector target populations— was studied