Capitation payment systems and public mental health care: Implications for psychotherapy with the seriously mentally ill.

The evolution, rationale, and implications of capitation payment systems in public mental health are discussed. These systems will unify the clinical, administrative, and fiscal structures of state and community mental health providers. Psychotherapeutic practice may shift to more action-oriented, problem-focused, brief and crisis interventions. The diminishing prospects for long-term intensive psychotherapy and the need to demonstrate its clinical efficacy and economic feasibility are discussed.