The purpose of performance measures is to evaluate and monitor how well a system responsible for providing mental health care is performing: to report the information in quantitative terms and to direct the system's efforts and resources toward desirable goals. The fundamental problem with defining such a set of indicators is the lack of consensus on these goals and, therefore, the lack of definition of what constitutes "good" performance.

The various stakeholders of the mental health system - consumers, family members, advocates, providers, purchasers, and policymakers - often have different expectations of the system. A purchaser may emphasize efficiency and cost, while a consumer may consider outcomes more important. One stakeholder may define a good system as one that contains costs and increases consumer satisfaction; another stakeholder may consider a system successful when it helps a consumer to participate productively in the life of the community. These different values and expectations of stakeholders in a system help to shape the character of the performance measurement system. They also shape the goals and objectives of the system, which, in turn, determine selection and ranking of performance indicators and the criteria by which performance is judged to be adequate. (See Chapter VIII: Measuring and Evaluating Outcomes.)

Recommendations:

a.

Utilize performance measures in budgeting, contracting, and managing mental health services.

b.

Involve consumers and families in mental health service evaluation.

c.

Attach funding to outcomes.