ABSTRACT
Probably in no other period in time has so much change in the field of health care taken place than during the past century. Breakthroughs and technological advances in the diagnosis, treatment, and prevention of diseases abounded during the 20th century. Never has so much progress occurred in such a relatively short period of time than what we have just witnessed. But at the same time, never have so much controversy, debate, and upheaval surrounding this country’s health care delivery system taken place as have occurred during the past decade. Out-of-control costs and the delivery of inefficient and sometimes ineffective services have led to drastic changes in this country’s health care delivery system. Few would disagree that the most drastic of these changes has been the introduction of what is referred to as “managed care.” This system not only affects the way treatment for physical problems is delivered but also the way in which behavioral health care-mental health and substance abuse services-is provided. Indeed, managed care has become the dominant force in the delivery of mental health care services (Cushman & Gilford, 2000). Depending on one’s point of view, the effects may be considered positive or negative. However, the general opinion that one is likely to uncover about managed care is a negative one.
