Managed Care and Unmet Need for Mental Health and Substance Abuse Care in 1998

Published in: Psychiatric Services, v. 51, no. 2, Feb. 2000, p. 177

Posted on on December 31, 1999

by Roland Sturm, Cathy D. Sherbourne

Read More

Access further information on this document at

This article was published outside of RAND. The full text of the article can be found at the link above.

Although managed care is generally associated with a reduced intensity of care, no recent national data are available about how plans using more or fewer managed care techniques differ in meeting the perceived needs of their enrollees. This report demonstrates the importance of defining access to care more broadly. If unmet need is defined as no care at all, as in previous studies, it would appear to have declined under managed care. However, no such decline is found when the definition also includes less care or delayed care. Thus, while managed care may have improved access to some treatment, significant problems remain in providing access to comprehensive care.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.