RESUMO
In 2005, New Mexico began a comprehensive reform of state-funded mental health care. This paper reports on differences in characteristics, infrastructure, financial status, and services across mental health agencies. We administered a telephone survey to senior leadership to assess agency status prior to and during the first year of reform. Non-profit/public agencies were more likely than others to report reductions or no changes in administrative staff. CMHCs were more likely to report a decline in their financial situation. Findings demonstrated that CMHCs, non-profit/public agencies and rural agencies were more likely to offer critical services to adults with serious mental illness.
Assuntos
Reforma dos Serviços de Saúde/organização & administração , Programas de Assistência Gerenciada/organização & administração , Serviços de Saúde Mental/organização & administração , Setor Público , Adolescente , Adulto , Pesquisas sobre Atenção à Saúde , Humanos , Programas de Assistência Gerenciada/estatística & dados numéricos , Transtornos Mentais/terapia , Saúde Mental , Serviços de Saúde Mental/legislação & jurisprudência , Pessoa de Meia-Idade , New Mexico , Administração em Saúde Pública/economia , Política Pública , População Rural , Índice de Gravidade de Doença , Inquéritos e Questionários , Telefone , População Urbana , Adulto JovemRESUMO
This column describes an initiative to reform the public behavioral health system in New Mexico, which has placed publicly funded services under the management of a single for-profit private corporation. The authors discuss problems that they attribute to the state's "top-down model of planning and implementation": complex documentation requirements that increase administrative burden on providers, unrealistically high expectations for a comprehensive information technology system, inadequate monitoring that hampers assessment of reform, and insufficient attention to the rural safety net. They call on other states to better incorporate experiences of those delivering and receiving services into the design and timing of reform initiatives.
Assuntos
Reforma dos Serviços de Saúde , Serviços de Saúde Mental/organização & administração , Formulação de Políticas , Humanos , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/legislação & jurisprudência , New Mexico , Inovação OrganizacionalRESUMO
The Federal government has promoted National Standards for Culturally and Linguistically Appropriate Services (CLAS) to reduce mental health disparities among Hispanic and Native American populations. In 2005, the State of New Mexico embarked upon a comprehensive reform of its behavioral health system with an emphasis on improving cultural competency. Using survey methods, we examine which language access services (i.e., capacity for bilingual care, interpretation, and translated written materials) and organizational supports (i.e., training, self-assessments of cultural competency, and collection of cultural data) mental health agencies in New Mexico had at the onset of a public sector mental health reform (Office of Minority Health 2001).