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Challenges,
Issues and Values in the Emerging Field of Outcomes in Children's Mental Health
The next list presented here in this summary of the dinner discussion involves the values that participants expressed in regards to what should be guiding the development of outcome accountability. The following list was identified by the participants:
Outcomes should directly feed into TA and training
This value was identified to stress the point that outcome information should guide technical assistance efforts and training that is aimed at improving service delivery."First of all do no harm"
Participants expressed concern that whatever outcomes are selected or whatever process is used to utilize the results that the processes do no harm to service providers or consumers. This value elicited different points of view. Some participants felt that it would be impossible to guarantee this value and that worrying about it would only slow progress in developing accountable mental health services. This point was reinforced by others in the group that felt that public mental health services were getting less and less funding because citizens are unsure about what Mental Health does and what it is trying to accomplish.Evaluations/outcomes as part of a system of care
Here the notion was presented that the original systems of care monograph (Stroul and Friedman, 1986) did not include outcome accountability as a key component. It was recommended that accountability be added to the existing framework.Outcome information should only assist decision-making rather than be the sole basis of making service delivery decisions
Judgment by consumers and from service delivery personnel was seen as crucial to include in the interpretation of outcomes and on the decisions that might follow. Participants expressed the concern that information on outcomes alone, although necessary, was not sufficient for the effective utilization of results.Can't trust outcomes to researchers
This value reflects the previous value. It was expressed that direct service workers, managers, family members and children should have a voice in the task of interpreting outcome information.Collaborative process
Participants stated that for outcome accountability to work effectively, its design and implementation needs to involve multiple perspectives from multiple stakeholders. "Buy-in" from those affected by an accountability system is crucial to the system's successful implementation and use.What interventions for whom and under what conditions
This value reflects the need to know more than just outcomes. Here it was pointed out by participants that information about who is served and what services were offered is crucial to later utilizing outcomes.Researchers bring technology
This value reflects the important role played by researchers and evaluators. There was consensus among participants that knowledgeable individuals should be consulted when designing outcome systems and in interpreting the findings.
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