ABSTRACT
This chapter examines the effect the commodification of mental health care on the work of mental health care providers. It argues that the ideology of managed care, which embraces cost-containment as its ultimate goal, is inherently incompatible with that of community-based care, which is generated by professionals. The chapter describes managed care and how it works. It considers the impact of managed care on mental health services, in terms of the ways in which managed care has changed the role of the provider and the resulting ethical dilemmas providers face in attempting to manage care within the confines of a commodity model. Managed care controls costs primarily by limiting clients' access to services and by limiting their utilization of more costly services by encouraging them to use less costly services. Howard M. Turney and Patricia Conway studied six managed health care plans and document ethical concerns confidentiality as well as clients' rights to services and self-determination.
