title: Managed mental health care: reflections in a time of turmoil.
abstract: This article reviews the history, growth, and evolution of managed care in mental health and substance abuse treatment. Specific issues described are stigma, the important social dimensions and chronicity of some types of mental illness and chemical dependency, and reliance on the public sector for care. Opportunities and challenges for occupational therapists in the rapidly changing mental health system are discussed, including the use of interdisciplinary teams, the importance of measuring functional outcomes of interventions, the need to develop clinical guidelines, the importance of the community setting and a continuum of services, ethical dilemmas, and the importance of assertive occupational therapy advocacy and involvement in health care reform.
authors.affiliation: School of Medicine, University of New Mexico, Albuquerque 87131-5641, USA.
authors.forename: B
authors.initials: B
authors.lastname: VanLeit
mesh_terms: D003266:Continuity of Patient Care; D004995:Ethics, Professional; D017408:Guidelines as Topic; D006801:Humans; D008329:Managed Care Programs; D008605:Mental Health Services; D009788:Occupational Therapy; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team