Any health care reform proposal will require that individuals be enrolled with a primary provider, will seek to contain costs, and will require prior approval for utilization of certain types of services and for services beyond a certain level . For the SMHA to protect the interests of people most in need, it will have to develop a capacity to acquire and analyze data that at least some states currently lack. This is a time of tremendous ferment and change in health care generally and in mental health care specifically. It is also a time of opportunity and risk. The state mental health agency will and must continue to exist, but its shape and functions in the twenty-first century will be significantly different from those it historically has played.
States turn to managed care to improve access and control costs.
United States Department of Health, Education, and Welfare. The evolution and expansion of mental health care in the united states between 1955 and 1990. Center for Mental Health Services, Mental Health Statistical Note 210, May 1994. National Association of State Mental Health Program Directors' Research Institute.