A mental health program report card: a multidimensional approach to performance monitoring in public sector programs

This report presents a comprehensive, multi-dimensional mental health program performance monitoring system that has recently been implemented in the Department of Veterans Affairs. Principles underlying the development of the system are reviewed and 68 specific monitors are described addressing four major performance domains: access, inpatient care, outpatient care, and economic performance. Simple methods are presented for identifying outliers, for generating summary performance scores across series' of related monitors, and for adjusting results for differences in patient characteristics across locales. Although still technically imperfect, and therefore requiring continuous improvement, monitoring systems such as the one presented can be useful tools guiding and improving service delivery and mental health system performance, and providing a medium of accountability to consumers and other stakeholders.