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Seeking Value

Balancing Cost and Quality in Psychiatric Care

Edited by Wesley E. Sowers, M.D., and Jules M. Ranz, M.D.
Group for the Advancement of Psychiatry

  • 2021
  • 643 Pages
  • ISBN 978-0-87318-226-3
  • Item #7226

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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.


  • Preface
  • Introduction
  • Part I: Where We Have Been
  • Chapter 1. Defining and Measuring Value
  • Chapter 2. Evolution of Funding and Quality Control in Health Care
  • Chapter 3. The Current System: The Mess We Are In
  • Chapter 4. Social Determinants of Health
  • Chapter 5. Successful Approaches to Increasing Value
  • Part II: Where We Want to Go: Systems Interventions
  • Chapter 6. Innovative Financing: Incentivizing Value
  • Chapter 7. Integration of Services
  • Chapter 8. Prevention and Health Promotion
  • Chapter 9. Peer and Recovery Support Services
  • Chapter 10. Applications of Technology
  • Part III: Where We Want to Go: Professional Interventions
  • Chapter 11. An Expanded Role for Psychiatry
  • Chapter 12. Psychiatric Workforce Development
  • Chapter 13. Pharmaceutical Management and Prescribing
  • Chapter 14. Diagnostic Reform
  • Chapter 15. Advocacy
  • Chapter 16. Psychiatric Leadership
  • Part IV: Special Value Opportunities
  • Chapter 17. Addiction Treatment and Harm Reduction
  • Chapter 18. Impact of Climate Change
  • Chapter 19. Incarceration Reform
  • Chapter 20. Health and the Workplace
  • Chapter 21. Aging and End-of-Life Care
  • Part V: Conclusions
  • Chapter 22. A Value Vision for Health Care Reform
  • Index


    George Alvarado, M.D.
    Elie G. Aoun, M.D.
    Ali Abbas Asghar-Ali, M.D.
    Margaret E. Balfour, M.D., Ph.D.
    Joseph Battaglia, M.D.
    Colleen Bell, M.D., FACHE, FAPA
    Victor J. A. Buwalda, M.D., Ph.D.
    Peter L. Chien, M.D., M.A.
    Allen S. Daniels, Ed.D.
    Bruce Fage, M.D., FRCPC
    Mark Graham, LCSW
    Elizabeth Haase, M.D.
    Ben W. Hunter, M.D.
    Kenneth G. Hunter
    Elizabeth Janopaul-Naylor, M.D.
    Michelle Joy, M.D.
    Gary J. Kennedy, M.D.
    Zev Labins, M.D.
    Frances R. Levin, M.D.
    Collins Lewis, M.D.
    Madeleine Lipshie-Williams, M.D.
    Nubia Lluberes, M.D., CCHP-MH, FAPA
    Gabrielle Marzani, M.D.
    Brian G. Mitchell, Pharm.D., BCPS, BCPP
    Keris Jan Myrick, M.B.A., M.S.
    Jorge R. Petit, M.D.
    Jules M. Ranz, M.D.
    Kyle E. Rodenbach, M.D.
    Patrick Runnels, M.D., M.B.A.
    Sy Atezaz Saeed, M.D., M.S.
    Manish Sapra, M.D., M.M.M.
    Deepika Sastry, M.D., M.B.A., FAPA
    Alessandra Scalmati, M.D., Ph.D.
    Amanda Semidey, LCSW
    Steven S. Sharfstein, M.D.
    Sosunmolu O. Shoyinka, M.D., M.B.A.
    Wesley E. Sowers, M.D.
    David A. Stern, M.D.
    Maria A. Sullivan, M.D., Ph.D.
    Arthur Robin Williams, M.D., M.B.E.
    Donovan Wong, M.D.

About the Authors

Wesley E. 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 Psychiatric Hospital in Pittsburgh, Pennsylvania.

Jules M. 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 Members
Andres Barkil-Oteo, M.D., Joseph Battaglia, M.D., Colleen Bell, M.D., Glen Davis, M.D., Bruce Fage, M.D., Joanna Fried, M.D., Elizabeth Janopaul-Naylor, M.D., Michelle Joy, M.D., Nubia Lluberes, M.D., Hunter McQuistion, 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

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