PSRO, quality review and mental health--a political and practical guide.

Quality assessment of mental health care is distinguished by it defensive character. The field has been sensitive to the criticisms of outside agencies and groups to the point of studying the quality of care it provides far more than other health providers have done. The result has been productive leadership in matters of practical evaluation. The author details the impact of PSRO, the JCAH, DRGS, and other formal review mechanisms upon the quality assessment process. He catalogs a shift in emphasis to take into account organizational dynamics and concludes that the JCAH seems to be propelling alcohol, drug, and mental health treatment programs into creative new directions.