Introduction: risk-adjustment issues in mental health services

State mental health authorities and other public and private entities are developing outcome measures and comparing results across providers, programs, and systems. To make comparisons equitable, outcomes must be risk adjusted. This article provides an introduction to mental health risk adjustment and outlines issues involved in the selection of outcome and risk variables, data collection protocols, and analytic methods. It stresses the importance of proper identification of risk-adjustment variables and models. The article concludes with the next steps necessary to develop a valid approach to the risk-adjustment methodology.