By J. Price Gittinger
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Washington, DC, American Psychiatric Association, 2000 Bennett MI, Bennett MB: The uses of hopelessness. Am J Psychiatry 141:559–562, 1984 Bennett MJ: Is psychotherapy ever medically necessary? Psychiatr Serv 47:966–970, 1996 Bittker TE: The industrialization of American psychiatry. Am J Psychiatry 142:150–154, 1985 Bonstedt T: Managing psychiatric exclusions, in Managed Mental Health Care: Administrative and Clinical Issues. Edited by Feldman JL, Fitzpatrick JP. Washington, DC, American Psychiatric Press, 1992, pp 69–82 Borenstein DB: Does managed care permit appropriate use of psychotherapy?
The better we understand MCOs, the more effective we become at advancing our patients’ rights and our own. We should know how to present evidence that will persuade care managers and physician advisors that the resources we request are well deserved. We should understand that a friendly demeanor is an asset throughout the appeals process and does not preclude legal or other challenges to a decision with which we disagree. We should regard an MCO’s needs as market opportunities to be identified and serviced while we seek alliances that will increase our influence in the marketplace.
35 No state-funded community beds were available for a schizophrenic patient whose parents were growing too old to care for her. Knowing that state services were more abundant where her brother lived, the patient’s clinician advised her to move in with her brother and establish residency in that area, and then apply for state benefits. Overwhelmed parents wanted to hospitalize their abused 6-year-old daughter because they could not protect her from her older brother. She was not otherwise at risk of harm.