Managing care across systems to improve outcomes for families and communities.

Behavioral health administrators deserve much credit for their efforts to integrate services for children with serious emotional disturbances and to instill a concern for efficiency through the concept of managed care. Recent changes in federal policy signal the next stage of development in systems of care. Issues of accountability now are shifting toward comprehensive systems of care and improving outcomes for families and communities, not just individuals. As they help build such systems in their states and communities, behavioral health administrators can help their colleagues in other systems understand the potential usefulness of concepts and practices associated with managed care and the broader notion of a system of care. In turn, they will be asked to expand their conception of the accountability of the mental health agency for the outcomes being experienced by families, neighborhoods, and the community as a whole.