Outcome evaluations in the mental health field

The legislative pressures now dominating the realm of program accountability are moving the mental health system from process to outcome evaluations. While the need for this type of assessment is generally acknowledged, its methodological validity and policy-setting utility are the subject of considerable controversy. Despite these concerns, outcome studies are expected to retain their present priority for some time to come. It is, therefore, essential that administrators, clinicians, and evaluators gain much greater clarity about the outcome study's intrinsic properties and requirements. These include its diverse organizational purposes, the several target populations affected by clinical services, the wide-ranging indices of effectiveness, and the numerous data collection instruments of varying psychometric quality. The outcome study's power to conclude whether causal linkages indeed exist between the clinical intervention and client functioning depends upon the sophistication with which these issues are recognized and resolved.