title: Implementation of a consumer-directed approach in behavioral health care: problems and prospects.
abstract: Consumer-directed care, a payment system designed to make patients aware of the costs of care, requires treatment seekers to be active participants in their health care. Core components of consumer-directed care, such as higher deductibles and increased decision-making responsibilities, might preclude its easy translation from medical to behavioral health care. Aspects of behavioral disorders will force providers, insurers, and patients to compensate for unique barriers to increasing self-care, such as stigma, neuropsychological complications, and poor self-efficacy. This column describes important components of consumer-directed care and the unique barriers that behavioral health care creates for those components. Possible best practices are suggested for surmounting those barriers.
authors.affiliation: Harvard Medical School, Division on Addictions, Cambridge Health Alliance, 10 Presidents Landing, Medford, MA 12155, USA. rlabrie@hms.harvard.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: LaBrie
authors.forename: Cheryl
authors.initials: C
authors.lastname: Browne
authors.forename: Donald E
authors.initials: DE
authors.lastname: Christensen
authors.forename: Kristina L
authors.initials: KL
authors.lastname: Greenwood
authors.forename: John H
authors.initials: JH
authors.lastname: Straus
authors.forename: Michael S
authors.initials: MS
authors.lastname: Garmon
authors.forename: Debi A
authors.initials: DA
authors.lastname: LaPlante
authors.forename: Stephen
authors.initials: S
authors.lastname: Scher
authors.forename: Allyson J
authors.initials: AJ
authors.lastname: Peller
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Shaffer
mesh_terms: D001521:Behavior Therapy / Q000191:economics*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003258:Consumer Behavior; D003657:Decision Making; D006801:Humans; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics* / Q000458:organization & administration / Q000639:trends*; D009483:Neuropsychological Tests; D010358:Patient Participation; D012648:Self Care / Q000706:statistics & numerical data; D020377:Self Efficacy; D013240:Stereotyping; D016896:Treatment Outcome; D014481:United States