Collision or collaboration? school-based health services meet managed care

Describes interactions of for-profit managed-care organizations (MCOs) with not-for-profit school mental health programs that are affiliated with school-based health centers (SBHCs). Discussion focuses on the developments and challenges that have emerged between SBHCs and MCOs. While relations between MCOs and more traditional forms of mental health services (e.g., community mental health centers) are becoming established, such relations with SBHCs remain far from established. The example of the pathway Connecticut has taken in the continuing dialogue between SBHCs and MCOs is described in detail. Attention is given to the advocacy groups for child and adolescent mental health that were instrumental in convincing legislatures to enact safeguards to maintain SBHCs as providers of health and mental health care in the era of managed care. Challenges and recommendations are outlined to insure that the mental health needs of underserved, disadvantaged children are met through the provision of school-based mental health services.