Article Abstract

Article Abstract

Online ISSN: 1099-176X Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 9, Issue 4, 2006. Pages: 185-192

Published Online: 21 December 2006

PERSPECTIVES
Convergence of Service, Policy, and Science Toward Consumer-Driven Mental Health Care

Christopher D. Carroll,¹ Ronald W. Manderscheid,² Allen S. Daniels,³ Amelia Compagni⁴

¹M.Sc., Public Health Advisor, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Washington, D.C., U.S.A.
²Ph.D., Director, Mental Health and Substance Use Programs, Constella Group, Rockville, Maryland, U.S.A.
³ Ed.D., Professor, Clinical Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
⁴ Ph.D., Research Fellow, Cergas, Centre for Research on Healthcare and Social Management, Bocconi University, Milan, Italy.

* Correspondence to: Christopher D. Carroll, M.Sc., 1 Choke Cherry Road, Room 6-1059, Rockville, MD 20850, USA
Tel.: +1-240-276 1765
Fax: +1-240-276 1320
E-mail: Christopher.carroll@samhsa.hhs.gov

Source of Funding: There were no governmental or private funds expended in the development of this article. The views and opinions of the authors do not necessarily state or reflect those of the associated public or private institutions.

Abstract

A common theme is emerging in sentinel reports on the United States health care system. This report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions. The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to widespread redesign of a consumer-centered mental health care system. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-driven programs. The growing availability of these services indicates that mental health consumers are expecting to be more participative in their mental health care.

Background: A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future.

Aims of the Study: The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions.

Method: The report reviews the relevant public mental health policy and data used in published work.

Results: The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system.

Discussion and Limitations: The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs.

Implications for Health Care Provision and Use: Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand.

Implications for Health Policies: Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where consumer-directed care is delivered in either the private or public health care systems.

Implications for Further Research: More research is needed to obtain further evidence on the use of consumer-driven services and their overall effectiveness.

Received 25 January 2006; accepted 23 August 2006