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Report: Managed mental health care gets failing grade
September 17, 1997
Web posted at: 10:40 p.m. EDT (0240 GMT)From Medical Correspondent Jeff Levine
WASHINGTON (CNN) -- Managed-care programs for severely mentally ill people receiving government assistance are failing to adequately serve patients, according to an assessment from the National Alliance for the Mentally Ill.
NAMI took a look at nine of the leading private managed-care plans that provide services to some 2 million patients on Medicaid, a program which serves the poor and disabled.
"In today's fierce competition, which is driven entirely on price, we have not seen a strengthening of access or quality," says NAMI's Laurie Flynn.
NAMI points to patients like Linda Duck, who has had run-ins with the access problem. At one point, Duck says she was forced out of the hospital prematurely because her insurance refused to pick up the tab.
CNN's Jeff Levine reports.
"It's inhuman, but that's the way they treat me," Duck said. "People that have mental illnesses aren't getting the right kind of treatment that they need."
NAMI surveyed managed-care plans on issues ranging from availability of state-of-the-art drugs to how they deal with suicide attempts.
"Most (plans) failed to specify that a suicide attempt is a medical emergency requiring medical care, emergency care," says NAMI's Laura Lee Hall.
However, the head of an managed-care industry group disputes NAMI's conclusions.
"There's more day treatment, there's more crisis intervention programs," says Clarke Ross of the American Managed Behavioral Healthcare Association. "There's more psychiatric rehabilitation. So there's a substitution going on."
In fact, industry sources say mental patients in managed-care plans are less likely to be hospitalized inappropriately. But consumer advocates say that too often, insurers are thinking more about the bottom line than patient care.
Armed with its survey results, the NAMI now plans to push for reforms -- at both the governmental and corporate levels.
"While we intend to press states and the federal government to assume their responsibility, the managed behavioral health industry certainly has to exert its leadership," Hall said.
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