Mental health quality and accountability: the role of evidence-based practices and performance measurement

Both evidence-based practices and performance measurement in mental health systems have been implemented as largely independent initiatives, each facing issues related to system-wide, sustained implementation. A major thrust of this article is that a broader quality and accountability framework is critical for obtaining better outcomes and for incorporating these initiatives into business as usual. This article provides an overview of national initiatives in these areas, lessons learned from implementation efforts, and problems encountered. Building on these experiences, a model for a quality and accountability framework is proposed in which evidence-based practices and performance measurement systems can together provide productive and ongoing synergy.