Mental health: emerging issues
The index page for the latest issue of Health Affairs, which focuses on issues related to mental health and mental health systems. See the following three postings below for links to free, full text versions of articles appearing in this issue. For other articles, abstracts are available at no charge, with full text copies of individual articles available for a fee. Single issues of Health Affairs can also be purchased at a cost of $35/each (the current issue is Vol. 22, No. 5, September/October 2003). Abstracts for other articles of interest to PULSE readers include - Is Prevalence A Good Measure Of Need For Services?; The Role Of Public Policies In Reducing Mental Health Status Disparities For People Of Color; Trends And Issues In Child And Adolescent Mental Health; Developing A Medicare Prospective Payment System For Inpatient Psychiatric Care; 'How Do You Pay Your Rent?' Social Policies And The President's Mental Health Commission, The 'Quiet' Crisis In Mental Health Services (a commentary piece), and The Impact Of State Managed Care Liability Statutes.  
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Accomplishments and Challenges in Medicaid Mental Health
Health Affairs article available in full text through Medscape - "Diane Rowland and her colleagues at the Kaiser Commission on Medicaid and the Uninsured detail the competing pressures states face to provide coverage and appropriate care within an environment of reduced resources. Cost containment strategies could well jeopardize the care of a vulnerable segment of the population, threatening to undermine the progress achieved in part through effective but costly drug therapies." [Viewing Medscape resources requires registration, which is free].  
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Managing Psychotropic Drug Costs: Will Formularies Work?
Health Affairs article available in full text through Medscape - "In this paper Haiden Huskamp explains that in the past payers have been reluctant to restrict the choice of psychotropic drugs through the use of formularies, because these drugs play a pivotal role in treating severe mental illness and allowing patients to return to productive life. However, as the price tag for this class of drugs continues to rise, it becomes a natural target of cost containment for insurers and pharmacy benefit managers. Huskamp examines whether the use of formularies for psychotropic drugs has promise or whether it has the potential to harmpatients and reverse some of the remarkable progress in mental health treatment that is partially attributable to the broad use of these drugs." [Viewing Medscape resources requires registration, which is free].  
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Mandated treatment in the community for people with mental disorders
Health Affairs article (in Adobe Acrobat format) - "The following paper explores the context within which coerced community treatment has arisen and seeks to break the impasse between advocates and opponents by placing mandated treatment within the larger conceptual framework of health care quality. The authors are all part of the Research Network on Mandated Community Treatment, a MacArthur Foundation funded project designed to evaluate programs in which mentally ill patients are instructed by the courts to get community-based treatment."  
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Magellan gets handle on its crippling debt
Baltimore Sun story - "Magellan's plan to complete its reorganization and emerge from bankruptcy won the approval yesterday of U.S. Bankruptcy Judge Prudence Carter Beatty in Manhattan. The restructuring wiped out about $600 million in debt by giving the lenders stock in the new company." The story also provides a business-oriented overview of Magellan's current state and prospects for the future - noting, for example, "Magellan also has a good shot at winning additional business from some clients who had been reluctant to contract with a company in bankruptcy, said one analyst, whose company policy precludes speaking for quotation. Another possible source of growth is parity legislation requiring that mental health benefits be equal to other health coverage..."  
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Study: Colorado mental health care, funding in crisis (Colorado)
Casper Star Tribune story - "Only one-third of Colorado residents who need mental health care actually get it and state funding to help those people is woefully inadequate, according to the first comprehensive assessment of its kind in a decade. The study of mental health needs, done by eight medical and nonprofit foundations, said one in five Colorado residents needs mental health treatment. And Colorado pays an average of $64 per person for mental health services, compared with $84 nationally. In addition, a higher proportion of children and adolescents need care and only half of the children from low-income families received treatment in 2000, the report shows. The 11-month statewide review revealed there is a particular lack of care for minorities and in rural areas of Colorado...." See also the page at coloradotrust.org on the Mental Health Funders Collaborative, which conducted the study. The page also provides links report highlights, the full report, "The Status of Mental Health Care in Colorado" and section-by-section files, as the full report is 304 pages long. All documents are in Acrobat format.  
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