Assessment tools in psychiatry.

With the advent of managed care, administrators of mental health care will need to implement outcomes measurement systems that will provide information for cost control and quality improvement. These systems must take into account the changes occurring in the delivery of mental health care, such as the broad range of settings in which mental health care occurs, and allow for the measurement of outcomes over time. A useful system must also be flexible, allowing measures to tailor the system to individual needs. Two types of systems are currently being used. Simple systems measure general outcomes, such as patient satisfaction, at baseline and discharge. More complex systems are disorder-specific and can be used to compare different types of treatments or different groups of patients. The simple systems are less costly but are not as useful to quality improvement. The disorder-specific systems are more expensive, but the information gathered with these systems can be used in quality management. As implementation of these systems becomes more commonplace, challenges such as lack of standardization, patient reluctance to fill out forms, and the need for sensitive measurement instruments will need to be addressed.