Historically, many states have created a system of community care for persons with serious mental illness by choosing a single model of rehabilitation services and propagating this model across the state. Managed care organizations are now duplicating this error. No one approach meets the needs of all individuals. By offering only one approach we limit consumer choice and the likelihood of meeting individual needs. As time passes a certain level of dissatisfaction grows because one model, no matter how effective it may be, does not serve all persons with serious mental illness.
Some states then abandon one approach and are convinced the next model is the magic answer.
And the cycle begins again to the detriment of consumers, providers and the state. If the funding stream is designed for a single model rather than for rehabilitation services in general, the situation becomes untenable. This is akin to reimbursing only behavioral psychotherapy or only Stelazine for medication. We would never consider such limitations in any other mental health services at the policy level. The provider is forced to provide an inflexible service and innovation is stifled.