Four assumptions underlie the stereotyped view of use of outpatient
mental health services: 1) all use is alike, 2) any use leads to high use,
3) all high use is discretionary, and 4) insurance encourages excessive
use. The authors refute the first three assumptions and suggest that
different types of treatment episodes vary in their responsiveness to
price. Diagnosis appears to be a poor indicator of inpatient needs; some
coverage limits outpatient benefits according to type of treatment. The
authors favor a combination of pricing strategies, as well as case
management and clinical review for high users, which would not impede
initial treatment but would limit excessive use of mental health
services.Abstract Teaser