National Alliance on Mental Illness
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Last Chance to Weigh In On the Future of How the Quality of Mental Health Care is Measured

The Center for Mental Health Services (CMHS) is moving full steam ahead to update thekinds of data that it will urge states to collect on the quality of mental health services. NAMI wants to urge you to review their plan and weigh in with them on how useful you think this is, what is good about it, and what may be missing. As you are reviewing it, think about whether this would be the information you would want to see if it was the only thing on which your state mental health department collected data. It is critically important that these performance measures for mental health servicescapture the needs of consumers and family members as they are used as a basis for federal grants programs to the states by the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS).

Action Needed!

To date, few family members and consumers have provided feedback. To weigh in on this important project, take the survey at by November 21, 2003 to give your input on whether or not these are the appropriate measures that should be used to determine the quality of mental health services. Please also forward this announcement to any e-mail lists of consumers and family members. If you have questions about this project, contact Vijay Ganju, Ph.D. of the National Association of State Mental Health Program Directors Research Institute at 703-739-9333 or Mary Smith, Ph.D., at 312-814-4948.

To read more about this initiative visit or see below.

Let them hear the consumer and family voice!

Background Information from MHSIP--the Mental Health Statistics Improvement Program

The mission of MHSIP is to foster and enhance the quality and scope of information for decisions that will improve the quality of life and recovery of people with mental illness. To do this, over the last two years, the MHSIP Policy Group, including Dr. Laura Lee Hall of NAMI, has sponsored an initiative to develop the next generation of mental health performance measures called The MHSIP Mental Health Quality Report. The purpose of this Quality Report is to maintain the momentum for developing and using performance measures that have a strong consumer orientation and help consumers move in the direction of recovery. The Quality Report represents a second-generation effort that builds on the MHSIP Consumer-Oriented Mental Health Report Card developed in 1996. The performance measures developed in that initial report have been the basis of the federal Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) grant programs to states. At the same time, other performance measurement initiatives -  the National Association of State Mental Health Program Directors (NASMHPD) performance measures initiatives, the American College of Mental Health Administrators (ACMHA) initiative, American Managed Behavioral Healthcare Association (AMBHA), National Committee on Quality Assurance (NCQA), Forum on Performance Measures for Behavioral Health and Related Service Systems -- have used the MHSIP work to inform their own endeavors. The report card also was endorsed by several advocacy organizations including NAMI, National Association of Mental Health Planning and Advisory Councils (NAMHPAC) and the Association of Ambulatory Behavioral Healthcare. Standardization of measures has occurred through a five-state feasibility study, a sixteen-state performance indicator study and the 50-state Data Infrastructure Grants initiative sponsored by the CMHS and through initiatives to combine and consolidate survey instruments and performance measures across the public and private sectors.

Two years ago, a workgroup consisting of consumers, family members, providers, managed behavioral healthcare organizations, advocacy groups, and state mental health agency representatives was formed by the MHSIP Policy Group with support from CMHS. The charge to the workgroup was to build on lessons learned in the development and implementation of mental health performance measures, in particular the MHSIP Report Card. The charge recognized that different sets of measures are needed for different populations in different settings but that a major emphasis was to develop commonality and consistency across these sets.

Workgroup members were selected on the basis of their connections to organizations that had experience with performance measurement. Organizations represented on the workgroup include: CMHS, NASMHPD, AMBHA, NAMI, National Mental Health Association (NMHA), Federation of Families for Children's Mental Health, National Council for Community Behavioral Healthcare (NCCBH), state planners, NAMHPAC, National Association of Consumer/Survivor Mental Health Administrators, and consumer recovery measurement initiative representatives.

A key aspect of workgroup efforts has been to build on and coordinate with various mental health performance measure initiatives rather than working in isolation. The workgroup has worked with the SAMHSA-sponsored Performance Measurement Forum, the Outcomes Roundtable for Children and Families, the What Helps and What Hinders Recovery Research Workgroup and a Consumer Expert Panel to develop its products.

We are now at a stage where we would like to solicit your response and suggestions regarding what we have developed up to this point. A major aspect of the charge to the workgroup was to develop performance measures for different populations and different settings. To address this, the workgroup is proposing a set of 'universal' measures, which would apply to all populations in all service settings. That is, these universal performance measures would be the fundamental building block of any mental health performance measurement system. In addition to these universal measures, specific performance measures are proposed for specific sub-populations and settings. In the survey, we are seeking your organization's input regarding the completeness of these sets and any refinements or revisions that you would like to see addressed or included.

A major concern of the MHSIP community is that the implementation of performance measures has not been done in a coordinated manner and frequently critical measurement components are excluded. While MHSIP is sensitive to issues of administrative burden and interpretation of measures, a key aspect of the MHSIP proposal is that any set of performance measures should be able to address the following key questions for any mental health services organization or service delivery system:

-Are people who need services getting services?

-Are services received of high quality and appropriate to consumers’ needs and preferences?

-Are people receiving services getting better?

-Are resources being used efficiently?

We recognize that, in addressing mental health performance measures, we are dealing with a "moving target." The field is developing rapidly and there are various activities occurring in parallel fashion under different organizational rubrics. We would like to benefit from your experiences and perspective to develop priorities for the implementation, development and testing of the next generation of performance measures.

To facilitate this process,we have developed a web-based survey, which can be accessed at On the survey, at a minimum, we are seeking your input related to the importance of different performance indicators and the identification of any critical ones that may be missing. You can either respond to this survey for your organization or disseminate this to your members so they can respond directly. We have also provided mechanisms to provide comments on the operational definitions of performance measures that have been developed by the workgroup.

Please log on to the MHSIP website to submit your response.

We would appreciate it if you could complete and have your members respond to the survey by November 21, 2003.