What should non-US behavioral health systems learn from the USA?: US behavior health services trends in the 1980s and 1990s.

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Title: What should non-US behavioral health systems learn from the USA?: US behavior health services trends in the 1980s and 1990s.
Authors: KISHI, YASUHIRO (AUTHOR), KATHOL, ROGER G. (AUTHOR), MCALPINE, DONNA D. (AUTHOR), MELLER, WILLIAM H. (AUTHOR), RICHARDS, STEVEN W. (AUTHOR)
Source: Psychiatry & Clinical Neurosciences. Jun2006, Vol. 60 Issue 3, p261-270. 10p. 5 Charts.
Subjects: Mental health services, Payment systems, Psychiatric diagnosis, Mental health insurance, Medical care
Geographic Terms: United States
Abstract: Several countries, such as the USA, inadvertently created a different behavioral health payment system from the rest of medicine through the introduction of diagnostic-related group exemptions for psychiatric care. This led to isolation in the administration and delivery of care for patients with mental health and substance abuse disorders from other medical services with significant, yet unintended, consequences. To insure an efficient and effective health-care system, it is necessary to recognize the problems introduced by segregating behavioral health from the rest of medical care. In this review, the authors assess trends in behavioral health services during the last two decades in the USA, a period in which independently managed behavioral health care has dominated administrative practices. During this time, behavioral health has been an easy target for aggressive cost cutting measures. There have been no clinically significant improvements in the number of adults receiving minimally adequate treatment or in the percentage of the population with behavior health problems receiving psychiatric care with the possible exception of depression. While decreased spending for behavioral health services has been well documented during this period, these savings are offset by costs shifted to greater medical service use with a net increase in the total cost of health care. Targeting behavioral health for reduction in health-care spending through independent management, starting with diagnostic procedure code or diagnostic-related group exemption may not be the wisest approach in addressing the increasing fiscal burden that medical care is placing on the national economy. [ABSTRACT FROM AUTHOR]
Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: What should non-US behavioral health systems learn from the USA?: US behavior health services trends in the 1980s and 1990s.
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  Data: <searchLink fieldCode="JN" term="%22Psychiatry+%26+Clinical+Neurosciences%22">Psychiatry & Clinical Neurosciences</searchLink>. Jun2006, Vol. 60 Issue 3, p261-270. 10p. 5 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Mental+health+services%22">Mental health services</searchLink><br /><searchLink fieldCode="DE" term="%22Payment+systems%22">Payment systems</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatric+diagnosis%22">Psychiatric diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health+insurance%22">Mental health insurance</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care%22">Medical care</searchLink>
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  Data: Several countries, such as the USA, inadvertently created a different behavioral health payment system from the rest of medicine through the introduction of diagnostic-related group exemptions for psychiatric care. This led to isolation in the administration and delivery of care for patients with mental health and substance abuse disorders from other medical services with significant, yet unintended, consequences. To insure an efficient and effective health-care system, it is necessary to recognize the problems introduced by segregating behavioral health from the rest of medical care. In this review, the authors assess trends in behavioral health services during the last two decades in the USA, a period in which independently managed behavioral health care has dominated administrative practices. During this time, behavioral health has been an easy target for aggressive cost cutting measures. There have been no clinically significant improvements in the number of adults receiving minimally adequate treatment or in the percentage of the population with behavior health problems receiving psychiatric care with the possible exception of depression. While decreased spending for behavioral health services has been well documented during this period, these savings are offset by costs shifted to greater medical service use with a net increase in the total cost of health care. Targeting behavioral health for reduction in health-care spending through independent management, starting with diagnostic procedure code or diagnostic-related group exemption may not be the wisest approach in addressing the increasing fiscal burden that medical care is placing on the national economy. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Jun2006
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