Integration of community-based services for the severely mentally ill and the structure of public funding

A comparison of four systems

K. G. Provan, H Brinton Milward

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Despite strong interest by health care services researchers in studying community-based service delivery to persons with severe mental illness, few understand the relationship between the structure of public funding and differences in how mental health care delivery systems are organized. In particular, the structure of public funding may have a substantial effect on the nature and extent of integration among the various service providers that comprise a community's delivery network. Such an understanding is critical if mental health policymakers are to use their influence on funding to guide the structure of service delivery. To investigate this issue, we compared community mental health care systems in four U.S. cities. We found that services will be integrated regardless of the structure of public funding but that the structure of integration among providers will be affected. Specifically strong fiscal control by the state is conducive to delivery systems that are integrated through the core mental health care agency in a community, whereas weak fiscal control is more likely to result in decentralized integration among system providers.

Original languageEnglish (US)
Pages (from-to)865-894
Number of pages30
JournalJournal of Health Politics, Policy and Law
Volume19
Issue number4
StatePublished - 1994
Externally publishedYes

Fingerprint

Social Welfare
Mentally Ill Persons
funding
Delivery of Health Care
Mental Health
mental health
community
Community Networks
Integrated Delivery of Health Care
health care
Systems Integration
health care delivery system
Community Health Services
health care services
mental illness
service provider
Health Services
Research Personnel
human being

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Policy
  • Nursing(all)
  • Social Sciences (miscellaneous)
  • Health(social science)
  • Law
  • Health Professions(all)

Cite this

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