Mental health service quality control: An idea whose time has come

Abstract

One of the battlegrounds in the war to provide adequate mental health services for every American is the area of service quality control. The advance guards are already present on the field and have such names as peer review, utilization review, cost control, and limitations on reimbursement. The remarkable increase in medical malpractice suits is also an indication of impending battle. Such suits can be successful only with changes in relationships between physicians and patients and in attitudes regarding their respective rights and roles. Although up to this point the preliminary skirmishing has been mainly between physicians and their representatives on the one side, and purchasers and users of medical service on the other side, clearly the number and variety of the warriors is about to increase. For example, as the distinction between treatment by psychiatrists and by other kinds of mental health professionals breaks down, all the mental health professions will likely become involved. As health insurance firms increase their coverage of treatment for mental illness, they and all those who purchase their policies will become more concerned. It is important then for all of us as mental health professionals, as citizens, taxpayers, insurance purchasers, and as occasional users of mental health services to examine the background of this battle, consider what its results may be, and see whether there may not be an opportunity for constructive intervention.