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Crisis intervention. Interpretation and practice by HMOs.

The Health Maintenance Organization Act' and its subsequent clarifications2 stipulated that federally qualified HMOs must provide "short-term (not to exceed 20 visits), outpatient evaluation and crisis intervention mental health services." Neither the original law nor its regulations define crisis intervention or specify its nature. This lack of definition presents an interesting demand on personnel in HMOs who provide and monitor outpatient mental health services, determining the types of services that will best meet patients' needs. Without a definition in law, it becomes a matter of practical interest to determine how HMOs define "crisis intervention," since the services they offer must depend on the definitions they use. The literature reports little data about actual HMO practices in providing crisis intervention services. In a comprehensive questionnaire survey of mental health services provided by HMOs, the authors gathered information concerning standards used in interpreting crisis intervention.