Epidemiology of mental illness in the United States: An overview of the cost effectiveness of psychotherapy for certain patient populations

Lazar, Susan G.

doi:10.1080/07351699709534153

Cited by 4 publications

(2 citation statements)

References 54 publications

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“…To the same end, a 1993 study presented to the White House Task Force for Health Care Reform showed that six-month courses of individual psychotherapy for war veterans diagnosed with posttraumatic stress disorder helped restore even the most severely traumatized veterans to productive roles in both work and family. 22 Similar arguments have been made for the efficacy of long-term psychotherapy-and the inefficacy of the brief therapy at-all-costs approach demanded by managed care-in the treatment of recurrent depression, multiple personality disorder, chronic substance abuse, posttraumatic stress disorder, and other illnesses. 23 It is not surprising then that many articles defending unmanaged psychotherapy conclude that managed care's restrictions are often enforced at the expense of a successful treatment outcome.…”

Section: Time and Moneymentioning

confidence: 98%

Psychotherapy, Managed Care, and the Economy of Interaction

Metzl

1998

APT

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Much of the dispute over the value of long-term psychotherapy in a managed-care system has focused on issues of time and money. This paper reviews the arguments put forth by defenders of psychotherapy and by managed-care organizations, and then moves to reconceptualize the issue through the perspective of narrative literary theory.What do they do? They dialogue.-Freud! Faster than almost anyone expected, managed care has become the de facto national health policy.-George Anders2Why are managed-care companies so reluctant to deal with psychotherapy? As the implications of health-care reform sweep across America, why have insurance plans in every state offered only minimal coverage for mental illness, refused to admit many psychiatrists and psychologists into their treatment "networks," and severely restricted access to outpatient psychotherapy? And why do many psychotherapists, subsequently, harbor deepseated reservations about managed care? In an age where the business model is supplanting the out-of-control medical model, these developments do not seem to make sense for one simple reason: mental illness is big business. In a system presumably fueled by demand and, if enough demand, supply, there is an unending supply of demand. In any given year nearly 30 percent of the (non-institutionalized) American population between the ages of 15 and 54 will meet the criteria for a mental illness. 3 Of these, only 15 percent will seek treatment with a health-care professional.Over the course of a lifetime it has been estimated that 50 percent of the population will suffer from a psychiatric disorder as defined in the Diagnosfic and Statistical Manual, of which fewer than 40 percent will receive any type of treatment. 4 Moreover, recent surveys have suggested that up to 97

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Section: Time and Moneymentioning

confidence: 98%

Psychotherapy, Managed Care, and the Economy of Interaction

Metzl

1998

APT

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“…Benefit managers, who are evaluated on an annual basis, have no incentive to pay for long-term savings. The fact that psychotherapy demonstrably reduces overall medical expenses (Dossmann, Kuttner, Heinzel, & Wurmser, 1997; Gabbard, Lazar, Hornberger, & Spiegel, 1997; Lazar, 1997) and probably reduces expenses for incarceration, drug abuse, posttraumatic enactments, and other costly accompaniments of psychopathology, while increasing productivity and life satisfactions that go well beyond simple symptom reduction, does not figure into a private insurance company's calculations. A close friend of mine was hired as the CEO of a managed care company insuring poorer families.…”

Section: Suspected Etiologymentioning

confidence: 99%

Preserving Our Humanity as Therapists.

McWilliams¹

2005

Psychotherapy: Theory, Research, Practice, Training

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Psychotherapists have traditionally embraced core values and beliefs that differ significantly from many values and beliefs that pervade contemporary, commercially oriented Western cultures. With their clients, therapists often question or challenge the culture's materialism, consumerism, appeals to vanity and greed, disdain of dependency and vulnerability, and abetment of narcissistic entitlement. Currently, however, psychotherapy is being reshaped by descriptive psychiatric diagnosis, pressures from powerful corporate interests, and antagonism from influential academic psychologists and is threatened with becoming the servant of the surrounding culture rather than its participant/observer and critic. The author notes symptoms of this trend and offers ideas about reversing it.

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National Priority Needs: Implications for Clinical Psychologists in the United States

Callan

1998

Comprehensive Clinical Psychology

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Epidemiology of mental illness in the United States: An overview of the cost effectiveness of psychotherapy for certain patient populations

Cited by 4 publications

References 54 publications

Psychotherapy, Managed Care, and the Economy of Interaction

Psychotherapy, Managed Care, and the Economy of Interaction

Preserving Our Humanity as Therapists.

National Priority Needs: Implications for Clinical Psychologists in the United States

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