Monday, December 08, 2008

Psychologists do all the work underpinning Community Support Services for mental health & receive no pay for it

Its amazing, really, when you start to understand that Community Support Services (CSS), is completely dependent on the Psychological Assessment. This document, signed by the doctoral Licensed Psychologist is what allows CSS to go through----or not.

Moreover, the Psychological Assessment is necessary in order for state funded clients to receive outpatient therapy.

Under the old NC DHHS system, the assessment of a psychiatrist or psychiatric nurse practitioner, replete w/ the DSM IV diagnosis would do.

Not so as pertaining to the increasingly rigid expenditure of CSS $$$ which demand clear linkages to behaviors and mental health challengegs.

No, for that you need a psychologist. And what does the psychologist get paid for meeting with the client for an hour or more, sitting down and writing up the report?

About $100.

The Psychological Assessment must include:

* the mental health and behavioral history of the client
* check about 20 boxes associated w/ demographic data
* speak to substance abuse history issues and details
* document educational matters
* overview the mental status associated w/ afffect, thought content, attention, orientation,memory, insight, risk of harm,risk to others
* rate current impairments
* render a five axis DSM IV diagnosis
* determine a target population
* fold into the report items supportive (or not) of CSS
* provide an Assessment Interpretation and Case Formulation
* make recommendations; sign your name and put your license on the line.

Absolutely amazing how NCPA has not done anything w/ these kinds of challenges and few psychologists even understand NC Mental Health Reform because no one wants to do this work.

DUH: I wonder why.

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