What's killing psychiatry?

Part 6

by Lisa Birk

Richard Sheola is more sanguine. Sheola is CEO of Massachusetts Behavioral Health Partnership, the company that administers mental health services to state Medicaid patients. He believes the two masters are yoked, pulling in the same direction: Partnership, he explains, profits not just from spending less than the cap, but also from administering better care.

When Partnership contracted with Massachusetts to manage the state's Medicaid mental-health program, the contract stipulated that some of Partnership's profit would come from meeting a set of "performance standards." Some of those performance standards are administrative (paying claims within a certain number of days) and some are therapeutic (finding a person in crisis a hospital within three hours). Meet those standards and both the company and the patients benefit.

Sheola believes the program is working well for everyone. In its first year managing Medicaid's mental-health services, Partnership met or exceeded all 10 performance standards and ran in the black. He and others associated with Partnership point proudly to the fact that the Alliance for the Mentally Ill of Massachusetts (AMI), a grassroots organization for the mentally ill and their loved ones, received just three complaints about Partnership in the company's first 11 months of operation -- a phenomenally low number, considering that Partnership serves 80,000 patients.

But the number of complaints is hotly disputed. The Boston AMI office sticks by the figure of three, but other AMI representatives say that can't be accurate. Ronnie Darlington, whose experience with her son's tragic early release led her to work as an assistant advocate for AMI of Western Mass, says she receives 12 to 15 complaints about Partnership a month at her office alone. Mostly, she says, people complain about clockwatchers. They complain that treatments and hospital stays are far too short, jeopardizing their loved ones.

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Lisa Birk is a freelance writer living in Cambridge.