Seeking Value : Balancing Cost and Quality in Psychiatric Care

Health indicators in the United States are among the worst in the developed world, even though its health care system is, by a wide margin, the most expensive in the world. It is a disparity that stems from a fragmentation of services and financial arrangements that often prioritize commercial interests over public health.

Seeking Value: Balancing Cost and Quality in Psychiatric Care, a comprehensive volume by the Group for the Advancement of Psychiatry's Mental Health Services Committee, examines the myriad factors that have led to the current state of health care in the United States -- starting with an analysis of the meaning and history of value measurement -- but it does not stop there. It offers a holistic vision for health care reform, one in which psychiatric professionals play a pivotal role.

A section on system interventions tackles traditional models of financing health care and the role of market forces as it considers broad public health strategies, from elimination of administrative waste to integration of care, that can reduce costs and improve population health, with a special emphasis on the interaction between mental and physical health.

Recognizing that these larger-scale interventions require time to bear fruit, the book also explores the ways the psychiatric profession and individual psychiatrists can contribute to a more skill-diverse, collaborative, activist, value-conscious, and visionary specialty.

Several chapters also identify public policy issues and cultural constructs that go beyond the typical role of clinicians and health care administrators, but that have the potential to impact population health in significant ways, illustrating how different choices could result in remarkable improvements in social well-being. The incorporation of healthy practices in the workplace, efforts to mitigate the impact of climate change, and the elimination of counterproductive incarceration practices all feature in this discussion.

Exhaustive in approach, the book aims to spur thought, conversation, and action to improve value in the services the psychiatric profession provides and the systems in which it operates. Its clear and compelling message will equip readers to develop an advocacy agenda that will resonate with nonmedical stakeholders and the practical strategies needed to see it realized.

Wesley Sowers, M.D., is Clinical Professor of Psychiatry at University of Pittsburgh Medical Center, and Director of the Center for Public Service Psychiatry at Western PsychiatricHospital in Pittsburgh, Pennsylvania.

Jules Ranz, M.D., is Clinical Professor of Psychiatry in the Department of Psychiatry at Columbia University Medical Center in New York, New York, and Senior Advisor to Community Psychiatric Nurse Practitioner Fellowship, Community Healthcare Network.

Group for the Advancement of Psychiatry Mental Health Services Committee MembersAndres Barkil-Oteo, M.D., Joe Battaglia, M.D., Colleen Bell, M.D., Bruce Fage, M.D., Joanna Fried, M.D., Elizabeth Janopaul-Naylor, M.D., Michelle Joy, M.D., Nubia Lluberes, M.D., Jules M. Ranz, M.D., Manish Sapra, M.D., Deepika Sastry, M.D., Sunmolu Shoyinka, M.D., Mardoche Sidor, M.D., Anna Skiandos, D.O., Wesley Sowers, M.D., Michael Vergare, M.D., Donovan Wong, M.D