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Public vs. Private Responsibility for Mental Health Services

Public vs. Private Responsibility for Mental Health Services


Private HealthResponsibility Servicesreflects American ambivalence toward capitalism and socialized medicine. Wolfe’s comments capsulize several of the themes that dominated the Nashville conference: the rapid rise of the for-profit multihospital chains, the public sector’s siege mentality, and the validity of applying free-market principles to the mental health field. During the late 1960s the first investor-owned multihospital systems were formed, said Paul Dokecki, Ph.D., professor ofpsychology at Vanderbilt University. Today approximately 30 investor-owned chains command roughly 60 percent of the psychiatric proprietary hospitals in the United States, Dokecki said. This change in ownership raises a disturbing question: Will chains attach a higher priority to profit than to quality of car& Proponents of proprietary services, said Dokecki, argue that a free market should improve mental health care: private organizations will compete to offer better and more varied services than those of the public sector. However,James A. Prevost, M.D., a visiting scholar at the University of Virginia and former New York State commissioner of mental health, cautioned that a more pluralistic, competitive system may emphasize care for the middle class and thereby abandon the indigent. Robert F. Dendy, Ph.D., director of clinical services for Hospital Corporation of America, the largest owner of
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