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Insuring intensive psychotherapy.

Many private insurance programs that currently cover mental disorders eliminate intensive psychotherapies, including psychoanalysis, from the range of treatment options by placing restrictions on the number of visits covered. The authors examine the economics of intensive psychotherapy coverage and present data indicating that relatively few people in an insurance program with comprehensive mental health benefits use high cost forms of psychotherapy. They conclude that insurance coverage of intensive psychotherapy is feasible but suggest that further study of the goals of intensive treatment, potential demand for it, and the supply of qualified practitioners is needed.

Blue Cross Blue Shield Insurance Plans↗

Obstacles to utilization of prepaid mental health care.

The coverage of out-of-hospital expenses for mental health care through prepayment and insurance programs has been a major advance in removing the economic barriers to early detection, diagnosis, and treatment of mental disorders. However, obstacles to obtaining treatment block many eligible people from receiving help. The authors conducted a study among members of the United Auto Workers union to identify these roadblocks. Among the obstacles were differences in perceptions of need for treatment and in attitudes toward treatment, and lack of awareness of eligibility for benefits among three key groups - consumers, referral agents, and providers. The authors urge psychiatry to help in removing these obstacles.

Attitude of Health Personnel↗

Current issues in national insurance for mental health services.

The current economic crisis has again placed in jeopardy the inclusion of mental health benefits under national health insurance. The author notes that progress has been made in establishing effective peer review systems and in demonstrating that costs of mental health services are reasonable. Yet the lack of agreement on diagnosis and appropriate treatment, the inadequacy of utilization, cost, and treatment outcome data, and the absence of professional self-regulation remain causes for concern in the effort toward eventual comprehensive coverage for mental disorders.

Costs and Cost Analysis↗

Milieu therapy: toward a definition for reimbursement.

The authors identify certain essential elements and processes within the milieu therapy approach that could provide the basis for reimbursement of this treatment modality under insurance. They also examine a philosophical framework, various guidelines, and a mechanism for accountability in the use of this form of treatment.

Costs and Cost Analysis↗

Psychotherapy fees and residency training.

Many residents in psychiatry tend to ignore their patients' attitudes and behavior concerning payment of fees for psychotherapy. The authors report on a new fee policy program designed to earn additional revenue for a low-fee outpatient psychotherapy clinic; they stress the therapeutic importance of resident and patient attention to fee-related issues.

Fees, Medical↗