Subject(s)
Child Guidance Clinics/legislation & jurisprudence , Community Mental Health Services/legislation & jurisprudence , Health Care Reform/trends , Adolescent , Child , Child Behavior Disorders/economics , Child Guidance Clinics/economics , Community Mental Health Services/economics , Eligibility Determination/legislation & jurisprudence , Health Care Reform/legislation & jurisprudence , Humans , Medicaid/legislation & jurisprudence , Substance-Related Disorders/economics , United StatesABSTRACT
In New York State and elsewhere, the lack of outpatient services results in inappropriate psychiatric hospitalization of children. Funding for specialized mental health services for children is not federally or state-mandated and county-levied dollars often are required to generate a state match. In New York State, counties relying exclusively on traditional sources of mental hygiene funding are unlikely to develop a variety of quality programs for children. This article discusses in detail how interagency collaboration developed in Dutchess County, New York resulted in procurement of funds that financed an array of children's outpatient mental health services to county residents.
Subject(s)
Child Health Services/economics , Community Mental Health Services/economics , Child , Child Guidance Clinics/economics , Child, Preschool , Continuity of Patient Care , Financing, Organized , Humans , Interinstitutional Relations , New York , Planning TechniquesABSTRACT
The current third-party fee-for-service mode of reimbursement for mental health services emphasizes individual, pathology-oriented intervention and thus has disadvantages for clients and carriers. This article focuses on the mode's effects on outpatient services for children, youth, and families. It examines the ways in which common payment modes seriously limit services and create an incentive for psychologists to take a narrow, often nonempirical, perspective. Suggestions that allow for multisystem, ecological skill building hinge on building relationships between psychologists and the carriers. Desired results take two forms: modification of contingencies between providers and carriers and modification of contingency between insured and carrier. Examples of each are presented.
Subject(s)
Child Guidance Clinics/economics , Community Mental Health Centers/economics , Fees, Medical , Insurance, Psychiatric , Adolescent , Child , Health Maintenance Organizations , Humans , Reimbursement, Incentive , United StatesABSTRACT
This paper discusses reasons for the apparent lack of interest by both the policy sciences and psychology in human service institutions and provides examples of the relationships between policy and politics and policy and economics in human service institutions. It suggests that two basic assumptions, labeled the professionalism myth and the individualism myth, have been major contributors to this state of affairs. Both the neglect given these institutions and the failure to examine the universe of alternatives in policy formulation are emphasized. Finally, the paper raises the question: Where has psychology been?
