Mental health social work and nursing in the USA and the UK: divergent paths coming together?

Background: When the mental health systems of the UK and the USA are compared, one of the most striking differences is that social workers are the largest professional group in the USA and community nurses the largest in the UK.

Aim And Method: This paper examines the history of the development of both professional groups in both countries, and their education and training.

Results: Demand, supply and economic factors are important influences and reasons for these differences.

Mental health and addictions services in resort communities: the case of Martha's Vineyard.

Resort communities face many behavioral health problems and challenges in service delivery. However, few discussions of these issues are present in the literature. Unique needs of rural and resort areas are described using Martha's Vineyard, MA, as a case example.

Guest editors' introduction: implementing evidence-based mental health practices and performance measures in Massachusetts.

In September 2005, a one day educational forum on implementing evidence-based mental health practices and performance measures in Massachusetts was held at Brandeis University. Factors for successful implementation are reviewed. Papers in this issue cover theory, concrete actions, and best practices that will aid policy makers, providers, and consumers in improving their behavioral health services.

Stakeholder perspectives on public managed behavioral care in Massachusetts.

The 2003 survey of Massachusetts behavioral health providers, as well as conference presentations by other key stakeholders, demonstrate continuing high ratings for the Massachusetts Behavioral Health Program. Key issues facing the program include improving integration, state funding cutbacks, movement into performance and outcomes measurement, and concerns about continuing stigma of mental illness. These issues are prevalent in other states that can benefit from the studies and perspectives of the Massachusetts experience.

Assessing consumer satisfaction in the Massachusetts Behavioral Health Partnership.

From 1999 to 2003, Consumer Quality Initiatives, Inc. (CQI) conducted peer interviews with 226 inpatient, 433 day treatment, and 822 outpatient clients of programs within the network of the Massachusetts Behavioral Health Partnership. Ninety-two percent of day treatment, 93% of the outpatient clients, and 79% of inpatient clients rated their care as satisfactory.

Managed behavioral health care: lessons from Massachusetts.

Since implementing the first statewide carve-out for behavioral health care in 1992, Massachusetts has achieved sustained reductions in cost, increases in access, and improvements in major quality measures. This introduction to a special issue describes the context, linkages with primary care, consumer satisfaction, unmet need, performance incentives (a key component of the success), stakeholder perspectives, and impacts on special populations.

Managed care and the quality of substance abuse treatment.

Background: In the US, the spiraling costs of substance abuse and mental health treatment caused many state Medicaid agencies to adopt managed behavioral health care (MBHC) plans during the 1990s. Although research suggests that these plans have successfully reduced public sector spending, their impact on the quality of substance abuse treatment has not been established.

Aims Of The Study: The Massachusetts Medicaid program started a risk-sharing contract with MHMA, a private, for-profit specialty managed behavioral health care (MBHC) carve-out vendor on July 1, 1992.

Evaluation of the Massachusetts Behavioral Health Program: Year 8.

The eight-year provider evaluation of the Massachusetts Behavioral Health Program showed positive assessments of care provision, continuing problems in integration of care, high assessments of the clinical review process, high evaluations for administration, and positive ratings compared with other managed care organizations. Changes in provider organizations continue. Substance abuse and mental health providers gave similar ratings, while inpatient providers were more critical than outpatient providers.