ABSTRACT
This chapter introduces the mental health service system, followed by an analysis of current policy issues as seen from the perspectives of mental health policy advocates and analysts. It discusses obstacles faced when providing long-term care for individuals with severe and persistent mental illness, and, in a broader context, how long-term care should be approached in health care reform. Moral hazard is a problem for general medical services as well as for mental health services, but the evidence suggests greater demand for the latter, thus justifying special restrictions. In contrast, medical management is a relatively low-cost service, generally less costly and less price-responsive than psychotherapy. From the patient's perspective, full integration of mental health and substance abuse services means that there would be no difference between insurance coverage for mental disorders and coverage for other health problems. The evidence for similar responses to utilization management is much more limited.
