Managing Care, Not Dollars: The Continuum of Mental Health Services

From our regular book review column.

Managing Care, Not Dollars calls us to shift our perspective on managed care from fear to embracement, from cost containment to the coherent delivery of state-of-the-art services. "The concept of the continuum of care with multiple components is not a new idea," we are reminded in the foreword: "It derives from community mental health principles and ideas developed in the 1960s as a means to provide continuity of care, a requirement in the early legislations for community mental health centers. . . . The movement toward managed care and capitation to reduce costs, with its profound impact on access and quality, provides the next stage for developing the continuum concept". Uncoupling traditional assumptions regarding location and service intensity, capitalizing on newer medications and technologies, and delineating parameters for hospital-alternative community-based care while employing principles of population and parsimony, accessibility, and flexibility are the basic elements set forth by the editors and contributing authors.