Aging and Mental Health Forum Forum On Managed Care Mental Health and Aging Managed care has not improved the delivery of needed mental health services to the aged and those with chronic illnesses. The Forum , sponsored by the National Coalition on Mental Health and Aging, was developed as a result of member organizations' concerns about the impact of managed care on the provision of mental health services to older Americans. The Keynote speaker was Gary Gottlieb, director and CEO of Friends Hospital in Philadelphia.
Full capitation is rare in the current managed care system.
Behavioral health care generally is carved out of the primary health plan with limited dollars. However, there are few model carve-out mental health plans that are appropriate for elderly clients and the chronically ill. Managed care delivery models are based on a primary care model for younger people that has been superimposed on geriatric and chronic care. Group counseling and over utilization of psychotropic drugs are two of the standard approaches of carve-out plans that are problematic for chronically ill and elderly people. Generally, primary care physicians serve as gatekeepers for diagnosis and referral for treatment, and they often lack needed knowledge of geriatric mental health.