A review of quality evaluation systems for mental health services

Mental health quality of care evaluation systems found in an extensive search are reviewed. The quality measures are differentiated from other seemingly similar types of scales and instruments. The quality systems are reviewed in reference to 1) reliability and validity of data, type, and source of data, allowance for patient variables, standards of quality, and other parameters and 2) range and comprehensiveness, particularly with regard to coverage of the range of disorders and conditions, of age groups, care needs, care settings, treatment modalities, and of types of provider performance. Most measures were reliable and valid. Some gave consideration to patient variables and case mix, to timing, and to treatment intensity. There were no measures of providers' interpersonal performance. With regard to range and comprehensiveness, there was a substantial imbalance toward the medical model and pharmacotherapy and away from systems orientation, from psychotherapy, and from other modalities, interventions, and types of programs.