Economic Grand Rounds: The Medically Indigent Mentally Ill: Approaches to Financing

Dr. Sharfstein's Introduction: Most mentally ill individuals do not have adequate insurance coverage for necessary treatment either in a hospital or in an outpatient setting. This problem has reached crisis proportions in the United States with the scaling down of public mental health systems and strong efforts by all payers to moderate overall medical costs. This month's column argues for an aggressive, revitalized public role in securing mental illness benefits, enforcing quality standards, and encouraging the most severely mentally ill to participate in treatment programs. Treatment for the mentally ill poor must be a major issue for the new Congress and administration. (1989)