Red Tape Squeezes Access to Mental Health Care

While competition among managed care organizations is thought to improve access to medical care, the "administrative burden" of juggling their policies and procedures may limit patient access to high-quality mental health services, according to a national survey of more than 7,000 primary care physicians.

"The red tape and administrative complexity of dealing with multiple health care plans is an impediment to physicians trying to help their patients get proper mental health services," says Benjamin W. Van Voorhees, M.D., senior clinical fellow in internal medicine at Johns Hopkins and first author on the report published in the May 2003 issue of General Hospital Psychiatry.

The study found that primary care physicians who interact with a large number of managed care plans may have the most difficulty getting high-quality mental health services for their patients. Important factors included the number of managed care contacts, the complexity of the referral process, amount of time spent on such non-patient care activities as filling out forms and concerns about financial penalties for clinical decisions.

Managed care organizations should place a higher priority on developing uniform, streamlined procedures for obtaining mental health services, such as thorough evaluations and successful treatments for psychiatric diseases like depression, according to Van Voorhees.

Other authors on the study are Nae-Yuh Wang, Ph.D., and Daniel Ford, M.D., both of Johns Hopkins. The study was funded by the National Institutes of Health.