Can Mental Health Be Included in the Health Maintenance Organization?

It seems evident that forthcoming changes in the health care system will include the development of health maintenance organizations. Prepaid group practice plans, a prototype of the HMO, have usually offered only modest mental health benefits, although there have been substantial improvements in recent years; utilization and costs under these programs have been low. The author discusses the barriers to inclusion of mental health benefits in HMOs, compares HMOs with community mental health centers, and calls upon psychiatrists to take an active role in ensuring not only that a mental health component be made an integral part of every HMO but that linkages be established between HMOs and other parts of the mental health care system.