Institute for the Study of
Healthcare Organizations & Transactions


  Psychiatric Diagnosis


How Do We Define Mental or Emotional Disorders?

Throughout the years, various mental/behavioral disorders have been defined in confusing and often conflicting ways.  The definition of a disorder can depend on such features as observable symptoms, e.g., crying, hallucinating; severity, e.g., crying/feeling blue for weeks or months vs. several days; and/or level of disability, e.g., going to work, school, and/or carrying out activities of daily living (bathing eating, dressing).  Usually mental health professionals rely on diagnostic criteria, the most widely accepted of which is the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV published by the American Psychiatric Association (1994).

Where do Individuals Receive Treatment?

Individuals who require treatment for mental of emotional disorders often see a mental health professional in private practice or they may consult with their primary care physician who then may make a referral to a mental health professional.  There are a number of types of mental health organizations in which individuals may receive treatment.  There are state and county public facilities, private psychiatric facilities, non-Federal general hospitals, hospitals operated by the Department of Veterans Affairs, and residential treatment centers for children and adolescents.


How Much Money Is Spent By Mental Health Organizations in the United States?

The pie chart to the right depicts the      percent distribution of expenditures, by the type of mental health organization, in 1994 (Source:  Center for Mental Health Services. Mental Health, United States, 1998)State mental hospitals accounted for 24% of the total expenditures in 1994 while Department of Veterans Affairs (VA) facilities accounted for just 4% of the total. Private psychiatric hospitals accounted for 20% of all expenditures, general hospitals, 16%, and all other mental health organizations, which includes community mental health centers, multiservice facilities and ambulatory services, accounted for 29% of all expenditures in 1994.  Finally, residential treatment facilities (RTCs) accounted for 7% of all expenditures in 1994.


Where Does the Money to Fund These Organizations Come From?

In 1994, revenues of the mental health organizations in the United States totaled $36 billion, which is an increase of $5.3 billion over 1992 (Source:  Center for Mental Health Services, Mental health United States, 1998).  The pie chart to the left depicts the sources of revenue. In 1994, 25% of the funds came from state mental health agency funds; 5% came from other state government sources.  20% came from the Medicaid program, while 14% came from Medicare.  5% came from other federal government sources. Client fees accounted for 18% of the revenues.  Local governments contributed just 8% of the total, contract funds accounted for 1%, and all other sources, 4%.



In the one of the pages below, we explain, in plain language, what Services Research is all about.  

In another page, we discuss Managed Care firms that specialize in mental health service delivery.

Visit our Hot Topics to read about new diagnostic entities in mental health and their proposed treatment.

In the future, we will be adding to these pages.  We invite you to click on, browse, and comment.



Lucy Canter Kihlstrom, PhD

Copyright 2000 Institute for the Study of Healthcare Organizations & Transactions

Last modified:  04.08.2010 02:58 PM