The dysfunctional side effects of quantitative indicator production: illustration from mental health care (a message...

In the current context of economic conservation, accountability and retrenchment from social programs, justification is required in order to maintain human service capacity. In this effort, evaluation is a key component. Yet desire to base action upon information resulting from evaluation must be tempered by increased attention to the effects of the evaluation process. All too often premature application of quantitative indicators formerly used for individual assessment and research to bureaucratic decision making produces side effects that are dysfunctional in nature. Frequently these side effects influence service delivery directly. More insidious, because they are less easily discerned, are distortions introduced into the data by evaluation pressure. These not only delay effects on service but also impair understanding of the very process they are meant to illuminate. In order to illustrate this phenomenon, the author reviews a general literature and utilized examples from mental health care. Common themes are identified and a tentative theory of side effect generation proposed.