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International efforts to measure and improve the quality of mental healthcare.

In the United States, the Institute of Medicine (IOM, a component of the National Academy of Sciences), beginning in 2000, has issued a series of reports identifying major problems in the quality of healthcare and providing detailed recommendations for reforming the healthcare system to improve the quality of care. In fact, the problems were seen as so significant to constitute not simply a gap between the qualities that should be present, but as a ‘chasm’. Among the IOM reports in this ‘quality chasm’ series was a 2006 report, ‘Improving the Quality of Healthcare for Mental and Substance Use Conditions’ [1]. The committee that wrote the report noted that quality issues were as prevalent and significant in behavioral health as in the rest of medicine. Moreover, although some tailoring to the specific attributes that distinguish care for mental and substance use conditions is needed, the same fundamental quality improvement strategies apply in this domain as in the rest of healthcare.