Evaluating the effectiveness of countywide mental health care systems.

This study evaluates the effectiveness of eight (four urban and four rural) Community Support Program (CSP) delivery systems located in a state in the northwest United States. Data were collected from 364 respondents: 156 service organization directors, 49 case managers, 77 family members, and 82 seriously mentally ill clients. Four measures of effectiveness were used: comprehensiveness (number of key services for the seriously mentally ill available), coverage (proportion of persons served who needed services), quality of services on a six-point scale, and services coordination (six-item scale). The four performance measures were found to significantly differentiate the eight counties. In five of six cases the measures were positively intercorrelated thereby confirming CSP claims that the key services are an integrated set and that it is feasible to provide a full range of services without sacrificing quality or hindering coordination.