Magazine article Personnel

Managing Mental Health

Magazine article Personnel

Managing Mental Health

Article excerpt

NEW YORK - "Is our society cracking up?" asked a senior HR vice president after he revealed that 40 percent of hospital days spent by his company's employees were related to mental illness.

This question no doubt would generate a wide range of answers from employers. But when it comes to responding to skyrocketing mental health costs, employers are more likely to give the same answer. Many companies that for years have provided employee assistance programs (EAPs) are starting to crack down on treatment and counseling expenses by adding managed mental health plans.

Industry estimates currently place the cost of mental health benefits in this country between $17 billion and $20 billion a year. Employers also can expect to see increases around 20 percent a year, according to a number of sources.

Managed care, a popular alternative for controlling medical care costs, has moved into the area of psychiatric and substance abuse treatment programs. Employers are considering and turning to so-called full carve-out plans that remove their companies' mental health benefits package design and management from the overall health benefits package.

Many of the same principles used to contain healthcare expenses are being applied to managed mental health, such as precertification, preferred provider networks, and utilization and quality assurance reviews. In turn, many of the same concerns that have been voiced regarding managed care for medical treatments are now being raised about efforts to control mental health costs.

"Managed mental health does not mean denial of care," said Dorothy Windham O' Shea, vice president of Benesys, a Houston-based nationwide firm that specializes in managed mental health. "Managed care means that you get the right level of care for the right amount of time. "

Three factors are critical for managed mental health, O'Shea said. "You need a benefits plan that allows for true flexibility, that is, a package that accommodates inpatient as well as day hospital, outpatient and group counseling benefits services." Many package designs in the past had almost no limits on inpatient benefits, but placed very restrictive rules for outpatient services, she added.

Managed mental health also requires a well-qualified network of providers that must be monitored at all times, according to O'Shea, who noted that networks do not place the same kind of restrictions as they do in medical and surgical care. "The average person has a regular general practitioner," she said, "but the average person does not have a regular mental health provider. …

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