WHILE there is an extensive literature on the evaluation of mental health programs, the state of the art in mental health program evaluation is unsettled, given the various competing criteria and methodologies that have been proposed. In spite of the long history of psychiatry, psychiatric programs remain among the most difficult to evaluate in the field of medicine.
A comprehensive view of a psychiatric program must encompass three related activities that are usually performed by groups of workers who are separated by training, tradition, and organizational barriers. These activities are (1) administrative and financial, involving the assignment of resources, eg, mental health workers, to a program; (2) clinical treatment; and (3) assessment of treatment outcome. In spite of the strong interrelationships, the three factors are usually treated as separate by the social system in which they are imbedded.
This paper offers new