ABSTRACT
This chapter focuses on the efforts in a specific public health sector, namely, mental health care for children and adolescents. It reviews the history and status of these efforts, dividing them into two periods. An early period that emphasized changes at the system or macro level, and a later period that developed multiple strategies for trying to improve the actual processes of care and their outcomes at more micro levels within service systems. The chapter presents three different strategies that are being used to address the need to improve quality of mental health care and therefore result in greater benefit to children and families receiving services in community settings. These are: dissemination of efficacious treatments in community settings; outcome assessment in community settings; and use of quality of care indicators in tracer conditions within service systems. One of the major shifts in the public mental health delivery system has been the relatively emphasis on outcome accountability.
