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Mental health and substance abuse services in the era of health care reform.

In the face of the cost crisis in the U.S. health care delivery system and in the era of reform, mental health and substance abuse services are in jeopardy. As the Clinton health reform plan is being debated during the months ahead, however, advocates for mental health and substance abuse care can play an important role in preserving benefits. To do so, they must press on with research into the effectiveness and cost-effectiveness of all aspects of mental health and substance abuse treatment; they must focus energies on working with managed care companies to ensure the provision of only necessary care at the appropriate level and intensity; and they must strive toward understanding the reforms being proposed and the implications for mental health and substance abuse services. Successful integration of the full array of mental health and substance abuse services into a generic benefits package remains a realistic goal, but the challenge is formidable.