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By Albert F. Blakeslee

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Thus, for access to mental and behavioral health and prevention services to continue to increase, medical utilization cost offsets must likelybe demonstrated, and then embraced as the economic means to achieve broader access to mental health services. MEDICAL AND BEHAVIORAL HEALTH CARE DELIVERY: INTEGRATION OR PARTNERSHIP? Dr. Cummings notes that because "carve-out" systems (behavioral health care, separate from medical health care) likely have maximized efficiency within mental health care delivery, the only way to expand services and efficiency maybe to re-integrate behavioral health care delivery with medical care delivery.

The immediate losers were the psychiatric hospitals and the solo practitioners of lor,g-term psychotherap3~ for itwasby reducing these overly utilized services that stability was quickly acquired. The beneficiaries were those who pay the costs and the patients who now had a new continuum of care. Managed behavioral care has resulted in an expansion of services as well as a substitution of services, with increases in psychiatric rehabilitation, day treatment, consumer-run peer support, residential treatment and crisis programs in lieu of psychiatric hospitalization and private practice psychotherapy; both of which declined and have never recovered (Cummings, 1999; Ross, 1998).

V. (1983). The somaticizing disorders: Illness as a way oflife. New York: Elsevier. Ford, C. V. (1986). The somatizing disorders. Psychosomatics, 27, 327-337. Gunn, W. , & Mauksch, L. B. (1997). Collaboration in action: Key stratgies for behavioral health providers. In N. A. A New Vision of Healthcare for America 37 Cummings, J. L. Cummings & J. N. ), Behavioral health in primary care:Aguidefor clinical integration (pp. 285-304). Madison, CT: Psychosocial Press. Hartman-Stein, P. ), (1997). Innovative behavioralhealth carefor older adults: A guidebookfor changing times.

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An Apparent Case of Non-Mendelian Inheritance in Datura Due to a Disease by Albert F. Blakeslee


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