| The advent of Medicaid managed behavioral health care has changed the ways that social work clinicians practice in mental health service systems, (Carpenter and Platt, 1997, Carpenter, 1999, Kaslow, 2000, Shapiro, 1995). The trend toward the private administration of publicly funded mental health treatment services-managed Medicaid, significantly impacts social work professionals as they are the traditional providers of mental health services to the poor. This study uses a survey methodology and both quantitative and qualitative analysis of survey findings, to explore social work clinicians' perceptions of their experiences practicing in a Medicaid managed care environment. To explore the perceptions of social workers about their practice, three hypotheses were proposed and investigated. No significant relationships were identified between the perceptions of social work practitioners with differing intensity of exposure to Medicaid managed care and their reported ability to practice in accordance with traditional social work values and mission, their ability to define problems collaboratively with their clients and to define the boundaries of their professional domain, and their ability to serve as advocates for their professional group in the domains of both policy and practice.; Further, the study explored whether any of several proposed theoretical perspectives can be used to provide a framework for understanding social work practitioners' perceptions about mental health services delivery in a managed care environment. Support for the use of a "Progressive Perspective" was suggested, and no support for the use of a "Social Control Perspective" was suggested. A "Competing Jurisdiction Perspective" was considered most useful helping to interpret the experience of the clinicians surveyed. |
