Mowbray C T, Herman S E
Eval Program Plann. 1986;9(4):335-44. doi: 10.1016/0149-7189(86)90048-0.
Since the introduction of federal mental health legislation in 1963, there has been a changing emphasis on evaluation and accountability. With direct federal funding of community mental health services, accountability demands were met through expectations for local agency evaluation activities which were overseen by federal authorities. The advent of the New Federalism and the shift to block grant funding of mental health services to state mental health authorities have shifted responsibility for evaluation to the states and local programs. This paper reviews federal mental health statutes to trace the extent and locus of required evaluation activities and discusses two approaches to carrying out program evaluation: "top-down" where the evaluation topic, method, and data collection are mandated by an administering or funding body; and "bottom-up" approaches where the subject, method of study, and data to be collected are developed in response to a felt need at the local agency level. A case study of each approach as used at the state level in mental health is examined. Based on the literature and the case studies, conclusions are presented on the pro's and con's of each method in meeting accountability demands and the barriers which must be overcome for either method to be successful.
自1963年联邦心理健康立法出台以来，对评估和问责的重视程度一直在变化。随着联邦政府直接为社区心理健康服务提供资金，通过对由联邦当局监督的地方机构评估活动的期望来满足问责要求。新联邦主义的出现以及向州心理健康当局提供心理健康服务整笔拨款资金的转变，已将评估责任转移到州和地方项目。本文回顾联邦心理健康法规，以追溯所需评估活动的范围和地点，并讨论开展项目评估的两种方法：“自上而下”方法，即评估主题、方法和数据收集由管理或资助机构规定；以及“自下而上”方法，即研究主题、研究方法和要收集的数据是根据地方机构层面的实际需求制定的。本文考察了在州一级心理健康领域使用的每种方法的案例研究。基于文献和案例研究，阐述了每种方法在满足问责要求方面的优缺点，以及每种方法要取得成功必须克服的障碍。
