Mental health quality and outcome measurement and improvement in Norway

To describe and discuss results from scientific articles in 2008-2009 on outcome and quality and improvement of these in the mental health services in Norway.

Good outcome is documented for several types of interventions and patient groups such as information campaigns to reduce duration of untreated psychosis, dynamic psychotherapy with transference interpretations for patients with less mature object relations, group and individual therapy for patients with personality disorders, parent training to reduce conduct problems in small children and opioid maintenance treatment to reduce deaths from overdose. At the same time, there is a lack of adherence in clinicians' prescriptions of antipsychotic medication, in patients' use of medication and of integrated treatment for psychiatric disorders and substance abuse. General practitioners' rating of mental health services may be a more valid quality indicator than patients' satisfaction. There is a lack of studies on quality, treatment fidelity, service improvements and implementation of best practice.

In spite of some documented treatments with good outcome, we know too little about the quality and outcome of the mental health services. Strategies for implementation of evidence-based treatment accompanied by research studies need to be the norm, not the exception.