Managed care for persons with serious mental illness

The rapid enrollment of Medicaid clients in private sector managed care plans has prompted considerable debate among consumers and policymakers about the extent that private sector techniques are transferable to vulnerable populations, such as persons with serious mental illness. Concern about these issues and the lack of empiric data to inform policy choices led the Substance Abuse and Mental Health Services Administration (SAMHSA) to initiate a 3-year (1996-1999) study at 21 sites to assess the impact of managed care on several vulnerable populations, including persons with serious mental illness. This article sets the background for these SAMHSA studies by addressing the relevant research findings related to the mentally ill adult population. The major question examined is whether managed care strategies, used to effect reductions in cost of mental health care in the privately insured population, can be duplicated for low-income, seriously mentally ill adults.