Under those terms, subjective emotional pain or nonlethal self-destructiveness may seem minor or even spurious. Even suicidal intention has sometimes not been deemed an emergency until the patient carries out an attempt. Instead of being honest and saying how much service the plan really covers, or that it only covers stabilization during crises or only medication, managed care companies say they offer the full range of mental health services, including much more care than they usually authorize. Then they give clients the message that they are denying continued care because the client's problem isn't serious enough, or else that their problem is too severe and they are untreatable. Plans are being sold that offer, for example, twenty outpatient psychotherapy visits per year, while in practice the number of visits is limited to two or three.
Privacy is a vital concern of mental health patients and clients.
Managed care companies routinely say they protect patients' confidentiality and then proceed to collect enormous amounts of personal information which may be seen by dozens if not hundreds of individuals, stored under unknown conditions, and shared or sold without the client's knowledge. When people are aware of how their private information is handled, they often decide to avoid therapy. When clients learn the realities, they usually express dismay or outrage. Information with clients' names and social security numbers is being casually faxed to the wrong numbers and lost in the mail. In summary, here is a list of suggestions for state legislation.