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Abstract

A version of this paper was presented as a keynote address entitled “Strategies for Catalyzing Change” at the September 2001 Annapolis Conference on Behavioral Health Workforce Education and Training. It explores some of the problems inherent in our present health care system and suggests that ultimately, revamping pre-professional training is the key to sustained system change. While the paper approaches the problems inherent in our behavioral health care system from a psychiatric perspective, it is believed that similar issues and concerns exist across disciplines and that ultimately the solution requires our ability to transcend narrower perspectives.

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REFERENCES

  • Accreditation Council on Graduate Medical Education. (2000). ACGME outcome project. American Association Directors of Psychiatric Residency Training. (2001). American Association Directors of Psychiatric Residency Training general competencies handbook. Annual meeting, Seattle, WA.

  • American College of Mental Health Administration. (2000a). Sounding a call to action: Training. Behavioral Healthcare Tomorrow, 9(3), 43–44.

    Google Scholar 

  • American College of Mental Health Administration. (2000b, June). Perspectives from inside the box. 2000 Santa Fe Summit on Behavioral Health: Changing the actions, strategies, and behaviors of clinicians, consumers, families, and organizations: The role of training and education. ACMHA Newsletter.

  • Bulger, R.J. (2000). The quest for the therapeutic organization. Journal of the American Medical Association, 283(18), 2431–2433.

    Google Scholar 

  • Davis, D., O'Brien, M.T., Freemantle, N., Wolf, F.M., Mazmanian, P., & Taylor-Vaisey, A. (1999). Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? Journal of the American Medical Association, 282, 867–874.

    Google Scholar 

  • Davis, D.A., Thomson, M.A., & Oxman, A.D. (1992). Evidence for the effectiveness of CME: A review of 50 randomized controlled trials. Journal of the American Medical Association, 268, 1111–1117.

    Google Scholar 

  • Davis, D.A., Thomson, M.A., & Oxman, A.D. (1995). Changing physician performance: A systematic review of the effect of continuing education strategies. Journal of the American Medical Association, 274, 700–705.

    Google Scholar 

  • Diagnosticand statistical manual of mental disorders (4th ed.). (1994). Washington, DC: American Psychiatric Association.

  • Frank, R.G., McGuire, T.G., Normand, S.T., & Goldman, H.H. (1999). The value of mental health care at the system level: The case of treating depression. Health Affairs, 18(5), 71–88.

    Google Scholar 

  • Goering, P. (2001). Comprehensive assessment of need and level of care determination study. University of Toronto: Center for Addiction and Mental Health.

  • Gurland, B., Sharpe, L., Simon, R., Kuriansky, J., Stiller, P., Farkas, T., Barrett, J., Fisher, B., Hoffganz, V., Goldberg, K., Copeland, J., Kelleher, J., Kellett, J., Gourlay, J., Cowan, D., Cooper, J., Kendell, R., Sartorius, N., Vickery, A., & Barron, C. (1974). Schizophrenia Bulletin, 11, 80–102.

    Google Scholar 

  • Hadley, T.R., & McGurrin, M.D. (1988). Accreditation, certification, and the quality of care in state hospitals. Hospital and Community Psychiatry, 39(7), 739–742.

    Google Scholar 

  • Hanson, K.W. (1998). Public opinion and the mental health parity debate: Lessons from the survey literature. Psychiatric Services, 49, 1059–1066.

    Google Scholar 

  • Hirschfeld, R.M., Keller, M.B., Panico, S., Arons, B.S., Barlow, D., Davidoff, F., Endicott, J., Froom, J., Goldstein, M., Gorman, J.M., Marek, R.G., Maurer, T.A., Meyer, R., Phillips, K., Ross, J., Schwenk, T.L., Sharfstein, S.S., Thase, M.E., & Wyatt, R.J. (1997). The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression. Journal of the American Medical Association, 277(4), 333–340.

    Google Scholar 

  • Hoge, M.A., Jacobs, S.C., & Belitsky, R. (2000). Psychiatric residency training, managed care, and contemporary health practice. Psychiatric Services, 51(8), 1001–1005.

    Google Scholar 

  • Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

    Google Scholar 

  • Institute of Medicine. (1995). Managing managed care: Quality improvement in behavioral health. M. Edmunds, R. Frank, M. Hogan, D. McCarty, R. Robinson-Beale, & C. Weisner, C. (Eds.). Washington, DC: National Academy Press.

    Google Scholar 

  • Jerrell, J.M., & Ridgely, M.S. (1999). Impact of robustness of program implementation on outcomes of clients in dual diagnosis programs. Psychiatric Services, 50, 109–112.

    Google Scholar 

  • Kandel, E.R. (1998). A new intellectual framework for psychiatry. American Journal of Psychiatry, 155(4), 457–469.

    Google Scholar 

  • Lehman, A.F., & Steinwachs, D.M. (1998). Patterns of usual care for schizophrenia: Initial results from the Schizophrenic Patient Outcomes Research Team (PORT) Client Survey. Schizophrenia Bulletin, 24, 11–20.

    Google Scholar 

  • McHugh, P.R. (1992a). Psychiatric misadventures. The American Scholar, 61(4), 497–510.

    Google Scholar 

  • McHugh, P.R. (1992b). A structure for psychiatry at the century's turn-The view from Johns Hopkins. Journal of the Royal Society of Medicine, 85, 483–487.

    Google Scholar 

  • McHugh, P.R. (1995). Dissociative identity disorder is a socially constructed artifact. Journal of Practical Psychiatry and Behavioral Health, 1(3), 158–166.

    Google Scholar 

  • McHugh, P.R. (1999). How psychiatry lost its way. Commentary, 108(5), 32–38.

    Google Scholar 

  • McHugo, G.J., Drake, R.E., & Teague, G.B. (1999). Fidelity to assertive community treatment and client outcomes in the New Hampshire Dual Disorders Study. Psychiatric Services, 50, 818–824.

    Google Scholar 

  • Mechanic, D. (2000). Managed care and the imperative for a new professional ethic. Health Affairs, 19(5), 100–111.

    Google Scholar 

  • Meyer, R.E., & Sotsky, S.M. (1995). Managed care and the role and training of psychiatrists. Health Affairs, 14(3), 65–77.

    Google Scholar 

  • Morris, J., & Stuart, G.W. (2002). Training and education needs of consumers, families, and front-line staff in behavioral health practice. Administration and Policy in Mental Health, 29(4/5), 377–402.

    Google Scholar 

  • National Depressive and Manic-Depressive Association Constituency Survey. (2001). Living with bipolar disorder: How far have we really come? Chicago, IL: Author.

    Google Scholar 

  • Norquist, G., & Hyman, S.E. (1999). Advances in understanding and treating mental illness: Implications for policy. Health Affairs 18(5), 32–47.

    Google Scholar 

  • Rosser, W.W., & Palmer, W.H. (1993). Dissemination of guidelines on cholesterol: Effect on patterns of practice of general practitioners and family physicians in Ontario. Ontario Task Force on the Use and Provision of Medical Services. Canadian Family Physician, 39, 280.

    Google Scholar 

  • Scott, C.D. (1996). How to manage change and enhance productivity in behavioral health care organizations. Presented at the Eighth Annual National Dialogue Conference on Mental Health Benefits and Practice in the Era of Managed Care. Behavioral Healthcare Tomorrow Syllabus, 531–539.

  • Torrey, W.C., Drake, R.E., Dixon, L., Burns, B., Flynn, L., Rush, A.J., Clark, R.E., & Klatzker, D. (2001). Implementing evidence-based practices for persons with severe mental illness. Psychiatric Services, 52(1), 45–50.

    Google Scholar 

  • Tsuang, M.T., Stone, W.S., & Faraone, S.V. (2000). Towards the prevention of schizophrenia. Biological Psychiatry, 48(5), 249–356.

    Google Scholar 

  • Wennberg, J.E., & Cooper, M.M. (1998). The Dartmouth atlas of health care in the United States: 1998. Chicago, IL: American Hospital Publishing.

    Google Scholar 

  • Whitelaw, N.A., & Warden, G.L. (1999). Re-examining the delivery system as part of Medicare reform. Health Affairs, 18(1), 132–143.

    Google Scholar 

  • Young, A.S., Klap, R., Sherbourne, C.D., & Wells, K.B. (2001). The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry, 58(1), 55–61.

    Google Scholar 

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Huey, L.Y. Problems in Behavioral Health Care: Leap-Frogging the Status Quo. Adm Policy Ment Health 29, 403–419 (2002). https://doi.org/10.1023/A:1019657224194

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  • DOI: https://doi.org/10.1023/A:1019657224194

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