THE ROLE OF EVALUATION IN THE RESTRUCTURING OF THE PUBLIC MENTAL-HEALTH SYSTEM

Major changes have occurred in mental health services in the last 20 years, but restructuring is still taking place. In order for evaluation to play a significant part in the future, its role in the past should be analyzed. A review of the literature describes evaluation activities in three major change areas: financial, programmatic/clinical, and new constituencies. Three areas of major evaluation activity but lesser importance to the public mental health system are also analyzed: prevention, needs assessment, and program performance measurement. From this review, suggestions are made to enhance future contributions. While increased support for evaluation and mandated evaluation involvement in major program/system change efforts would undoubtedly help, lessons from the past show us that such changes, alone, may have little impact. In addition, administrators' knowledge of research and evaluation and motivation to utilize findings must be increased. Suggestions are presented for a structured process of replication and reimbursement of nontraditional services, building in evaluation considerations. Besides the funding investment and clearer specification of program objectives that these suggestions will require, changes will also be necessary in developing alternative methodologies and instrumentation to improve consumer input.