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Abstract
This paper describes the mental health system in the United States from an economic perspective, addressing three questions: How much money is involved? Where does the money come from? How does it get spent? The answers stem from ten current trends in the mental health system:
- behavioral health spending has grown faster then GDP, slower than overall health care
- government's role in mental health has been large and growing
- state mental health systems have decentralized
- out-of-pocket payment rate has fallen
- inpatient care has declined relative to outpatient care
- medication has been on the rise relative to therapy
- primary care's contribution to mental health care has been relatively flat
- managed behavioral health organizations have taken over
- MBHOs have cut costs dramatically
- the parity movement has boosted mental health benefits, but its impact has been largely symbolic
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