Clinical services have been greatly reorganized recently, largely because of a transformation in healthcare financing (1, 2), of which cost-containment is an important component. Diminishing staterevenues and increasing Medicaid enrollments, along with the mounting costs of prescription Pharmaceuticals, have compelled most states to reduce drug spending (3). For instance, 46 states reduced Medicaid outpatient drug benefits in 2003 (4). Private insurance companies have also followed suit. These trends affect medical care overall but disproportionately affect psychiatric care, particularly, care funded through Medicaid. Psychiatric medications are among Medicaid's and private insurers' most costly and commonly prescribed drugs and, consequently, have been "fair game" for cost-containment initiatives (5).
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