Quality-of-care research in mental health: responding to the challenge

Quality-of-care research in mental health is in the developmental stages, which affords an opportunity to take an integrative approach, building on principles from efficacy, effectiveness, quality assessment, and quality assurance research. We propose an analytic strategy for designing research on the quality of mental health services using an adaptation of the structure, process, and outcome classification scheme. As a concrete illustration of our approach, we discuss research on a particular target population-patients with chronic schizophrenia. Future research should focus on developing models of treatment, establishing criteria and standards for outcomes and processes, and gathering data on community practices.