The impact of Medicaid managed care on the delivery of child mental health services at outpatient community mental health clinics in New York City

This qualitative study explores how a new financing system for mental health care—Medicaid managed care—has influenced the delivery of mental health services to children at outpatient community mental health clinics in New York City. Two geographic areas were targeted for this study: southwest Brooklyn where Medicaid managed care began in New York City and the greater New York City area. Nine clinic directors with years of administrative and clinical experience were interviewed. The directors shared their professional experiences with Medicaid managed care and discussed both positive and negative aspects of the new system. Data gathered from the interviews led to several findings: Medicaid managed care influences the administrative and financial functioning of all of the agencies. Medicaid managed care also affects professional and student training and professional morale. Furthermore, Medicaid managed care has changed the delivery of mental health services to children at outpatient mental health clinics. This study details changes in the types of treatment modalities that are used with child patients. Additionally, it details changes in access to mental health care as well as changes to the length and frequency of child treatment caused by Medicaid managed care.