Managed mental health care, which encompasses a wide variety of approaches, is a response to precipitous increases in health care expenditures, particularly as they relate to mental health care. The shift from what seemed certain to become a national health insurance program only 15 years ago to the profit-driven corporate health care industry of today is truly revolutionary. These profound changes are beginning to have a major impact on the independent practices of psychologists. In this article, psychologist practitioners are exhorted to recognize this new development in the marketplace. Data are cited that show the rapid shift from free choice care to various forms of managed care, and practitioners are urged to participate in shaping the changes that are now in process in order to develop a humane and effective system of mental health care.

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The number of psychologists holding academic appointments in schools of medicine is an index of the degree to which comprehensive medicine has advanced. It is also an indication of how viable the medical school is as an occupational setting for psychologists.A national manpower study conducted in 1976 and concluded in 1977 consisted of three modules: In the first module, chief psychologists in the 115 U.S. medical schools were surveyed regarding the number, sex, full-time-part-time status, and names of psychologists holding faculty appointments. (This survey is unique in that 100% of the medical schools provided usable returns.) Chief psychologists also were asked to indicate if they were voting members of their medical school faculties (Matarazzo,

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