Coordination, Continuity, and Centralized Control: A Policy Perspective on Service Strategies for the Chronic Mentally Ill

Chronic mentally ill persons in the community depend on an array of psychological, social, and medical support services that are delivered by public and private sources and are under the auspices of different levels of government. In response to problems of fragmentation and disorganization of these services, improved coordination has emerged as a major objective of contemporary mental health policymaking. This article describes the major coordinating approaches that have been developed, analyzes barriers to their implementation based on insights from the policy sciences and other literatures, and examines the basis of coordination's appeal as a service system reform strategy.

[1]  D. Rochefort Policymaking cycles in mental health: critical examination of a conceptual model. , 1988, Journal of health politics, policy and law.

[2]  J. Talbott The perspective of John Talbott. , 1988, New directions for mental health services.

[3]  L. Aiken,et al.  Improving the care of patients with chronic mental illness. , 1987, The New England journal of medicine.

[4]  J. Rubin Financing care for the seriously mentally ill. , 1987, New Directions for Mental Health Services.

[5]  C. Boyer Obstacles in urban housing policy for the chronically mentally ill. , 1987, New directions for mental health services.

[6]  J. Abramson,et al.  Competition, capitation, and case management: barriers to strategic reform. , 1987, The Milbank quarterly.

[7]  J. L. Franklin,et al.  An evaluation of case management. , 1987, American journal of public health.

[8]  K. Minkoff Resistance of mental health professionals to working with the chronic mentally ill. , 1987, New directions for mental health services.

[9]  B. A. Paradis An integrated team approach to community mental health. , 1987, Social work.

[10]  E. Torrey Continuous treatment teams in the care of the chronic mentally ill. , 1986, Hospital & community psychiatry.

[11]  J. Talbott,et al.  A proposal for future funding of chronic and episodic mental illness. , 1986, Hospital & community psychiatry.

[12]  D. Mechanic The challenge of chronic mental illness: a retrospective and prospective view. , 1986, Hospital & community psychiatry.

[13]  P. Solomon,et al.  Reconceptualizing assumptions about community mental health. , 1986, Hospital & community psychiatry.

[14]  M. Test,et al.  The dissemination and impact of a model program in process, 1972-1984. , 1985, New directions for mental health services.

[15]  J. Hoult,et al.  The Relatives of the Mentally Ill: A Comparative Trial of Community‐Oriented and Hospital‐Oriented Psychiatric Care , 1984, The Journal of nervous and mental disease.

[16]  J. Talbott Unified mental health systems : utopia unrealized , 1983 .

[17]  J. Talbott The future of unified mental health services. , 1983, New directions for mental health services.

[18]  B. Pepper,et al.  Unified services: concept and practice. , 1982, Hospital & community psychiatry.

[19]  J. Intagliata Improving the quality of community care for the chronically mentally disabled: the role of case management. , 1982, Schizophrenia bulletin.

[20]  J. Weiss,et al.  Substance vs. symbol in administrative reform: the case of human services coordination. , 1981, Policy analysis.

[21]  Walter S. Deitchman HOW MANY CASE MANAGERS DOES IT TAKE TO SCREW IN A LIGHT BULB , 1980 .

[22]  L. Stein,et al.  Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation. , 1980, Archives of general psychiatry.

[23]  M. Test Continuity of care in community treatment , 1979 .

[24]  I. Lescohier,et al.  2 Service Integration: Real Versus Illusory Solutions to Welfare Dilemmas , 1978 .

[25]  R. Alford,et al.  The Political Economy of Health Care: Dynamics Without Change , 1972 .