Development of outcome indicators for monitoring the quality of public mental health care.
OBJECTIVE
The study attempted to develop a brief and integrated set of reliable and valid outcome measures that could be used by both consumers and providers to assess the quality of public mental health care.


METHODS
A model of outcomes in four domains-consumer satisfaction, functioning, quality of life, and clinical status-was developed from the literature and from the priorities expressed by members of an advisory group of stakeholders. Based largely on extant measures, a consumer survey and a case manager survey were then created to assess these domains. A total of 236 adult consumers of mental health services from six community mental health centers in Washington State were surveyed. The four-item case manager survey to rate consumers' clinical status was completed by 163 of the participants' case managers. Scores and ratings on the survey were analyzed using correlational analysis and principal components analysis to determine whether the data provided empirical support for the four-domain model.


RESULTS
Principal components analysis demonstrated support for the four-domain model. Internal consistency of the outcome indicators was adequate, and their concurrent validity was partly supported.


CONCLUSIONS
The described outcome measures provide a practical, empirically supported structure for monitoring and improving public mental health services.
Srebnik
D
D
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA.
Hendryx
M
M
Stevenson
J
J
Caverly
S
S
Dyck
D G
DG
Cauce
A M
AM
D000203:Activities of Daily Living; D000328:Adult; D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D019538:Health Care Surveys / Q000379:methods / Q000592:standards; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000592:standards; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D011635:Public Health Administration / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards; D011788:Quality of Life; D015203:Reproducibility of Results; D012494:Sampling Studies; D012647:Self-Assessment; D012917:Social Adjustment; D012938:Social Perception; D011795:Surveys and Questionnaires / Q000592:standards; D014861:Washington