Historical Trends in Quality Assurance for Mental Health Services

  • Kenneth B. Wells
  • Robert H. Brook


Concerns about the quality of health services are as old as the healing professions. The modern concept of quality assurance, however, evolved in the twentieth century, chiefly in the United States,1 and has had lasting effects on the mental-healthcare delivery system. For example, the demands for accountability that quality assurance entails have stimulated a greater concern with the reliability and validity of mental health diagnoses and of measures of outcome. Similarly, the concept of peer review has stimulated reconsideration of the therapist- client (doctor-patient) relationship and the limits of confidentiality. Further, the difficulties inherent in instituting effective peer review have been cited as a partial justification for the current trends toward decreasing the insurance coverage of mental health services. And finally, quality assurance legislation has played a significant role in the developing conflict between mental health provider groups.


Mental Health Mental Health Service Quality Assurance Mental Health Care Community Mental Health Center 
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Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Kenneth B. Wells
    • 1
  • Robert H. Brook
    • 1
  1. 1.Rand CorporationSanta MonicaUSA

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