Quality and customers: a planning approach to the future of mental health services in a health maintenance organization.

Mental health service delivery is both a health care and business arrangement, and is accordingly impacted by national changes in both areas. HMO mental health services in the current health reform zeitgeist are being called on to provide more efficient, comprehensive integrated care. A planning effort is presented which is organized around (1) a quality improvement effort aimed at understanding who are the "customers" (patient, medical community, mental health staff, and client employer) and what they need and (2) coordination and integration with the HMO larger organizational plan and efforts. The unique benefits of staff model HMOs are discussed relative to mental health service.