Issues in the Evaluation of Systems of Mental Health Services: A Perspective and Recent Developments

If clinicians are not going to lead the efforts to provide effective services, there is a significant risk that efforts to develop services will continue to be driven more by economic factors than clinical outcomes. Few clinicians are engaged in systematic monitoring of the outcomes of their services. Few communities have a coherent strategy for determining when or whether services are effective. This, however, is not likely to continue. Purchasers of mental health services such as governments and employers are becoming concerned that their funds be used in as cost effective a manner as possible. Consumer advocacy groups are shifting from focusing only on the expansion of services to asking questions about the effectiveness of those services that are provided. Clinicians, therefore, can continue manifesting a lack of interest in monitoring outcomes only at their peril.