Managed Care Failing Mentally Ill, Advocacy Group Says Report Focuses On Large Companies That Provide Medicaid

Managed care plans are failing to handle the special needs of the mentally ill, an advocacy group asserted Wednesday.

In a report, the National Alliance for the Mentally Ill argued that managed care companies were not doing all they should to assure that the mentally ill get adequate hospital care or the most effective medication.

The report focused on large companies that provide Medicaid services for people with mental illnesses. Other plans are not addressed, but many have similar deficiencies, said Laura Lee Hall, the author.

“A catastrophe awaits people with serious brain disorders and their families, should managed care continue its march through the public mental health system unreformed and unregulated,” the report said.

The alliance is a grass-roots, nonprofit organization supported by private foundations. Its 168,000 members serve as advocates for people with severe mental illness.

A managed care trade organization responded that health plans are “dedicated to addressing the challenges” of serving the mentally ill.

“Health plans pledge to work with responsible organizations to improve the quality of mental health care,” said a statement from Susan Pisano, spokeswoman for the American Association of Health Plans.

Specifically, the survey of nine companies found:

Just one company had comprehensive, up-to-date treatment guidelines. Guidelines for schizophrenia, for instance, often do not mention the newest medications.

Only four companies provided adequate hospital care for patients. Some deny hospital care to patients who are disruptive, which is common among those with severe mental illness.

None offered access to the most effective medications or intensive case management.

None effectively engaged patients and their families in treatment.

The report said that while some companies were trying to provide good care for the mentally ill, others were contributing to a “litany of broken promises.”

Hall acknowledged that the government agencies that contract with managed care companies also are responsible for making sure essential services are guaranteed in the contracts they sign.

But she said managed care companies are quickly becoming the central caregivers to the mentally ill and must take responsibility.

“The history of the public mental health system is it’s always somebody else’s fault,” she said.