Community and State Hospital report

The chair discusses care giving in New York, and fewer regulations allowing more flexible treatment approaches

By Jim Regan, PhD

I have been thinking about what to write for a few months now. As some of you may recall, in the last newsletter edition, I reinforced the concepts of evidenced based treatments and insuring the element of science as a guide for our work in the ever changing field of mental health. Here in New York it has been anything but business as usual, and to some degree the provision of care to the mentally ill is undergoing a fundamental change. It is now about Health Homes and care giving and, quite frankly, positioning to be included in the provision of care for the treatment of the mentally ill Medicaid population. Taking a step back to view the field, it appears to me to be a movement toward managed care packaged in an integrated, physical health and behavioral Health Home. The good news is that along with the managed care approach should come some freedom from burdensome regulations that might allow for more flexible treatment approaches and those approaches have as their goal, improved client outcomes. These new flexible approaches will permit more innovative treatment. Last newsletter, I referenced the recent article by Kazdin and Blase (Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness), in the January 2011 issue of Perspectives on Psychological Science. They discuss and describe a number of different venues that have clinical value that are not the traditional, one on one or small group approaches. Under the technologies framework they discuss the use of the internet, telephone, and smart phone. Use of atypical settings (the most common being the general practitioners office) are considered. In addition they address the concept of self help as well as help from trained but not Doctorate level individuals. The message here is clear; we need to continuously look toward reaching the large number of individuals who are currently symptomatic as well as those who are at risk for mental illness. In seems evident to me that we need to broaden our view on how to best engage and treat.

This is always an interesting topic to chat about, feel free to contact me and continue our discussion.