Mechanic D
Institute for Health, Health Care Policy, Rutgers University, New Brunswick, New Jersey 08903.
Hosp Community Psychiatry. 1991 Aug;42(8):797-801. doi: 10.1176/ps.42.8.797.
Practical solutions to the issues troubling public mental health systems must be developed within the constraints of existing political structures. A key enabling factor is the inclusion of a broad range of reimbursable mental health benefits within health insurance. However, services cannot be improved without the development of viable frameworks for organizing effective service delivery; such strategies include assertive community treatment, capitation approaches, strong local mental health authorities, and reimbursement structures that achieve key objectives. The author discusses examples of the four strategies and argues for their better integration.