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Using accountability for mental health to drive reform

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Across the health care system, accurate measurement and frequent transparent reporting of patient experiences has the capacity to reduce variations in care and increase effective service provision.1 The merit of applying this principle to mental health is well understood.2,3 Over 20 years, four successive national mental health plans have each called for this kind of accountability. Despite the rhetoric, and as we now brace for a fifth plan, Australia still has no agreed set of priority indicators nor any process to enable useful benchmarking.

This is a critical management deficiency recognised by the National Mental Health Commission and the Mental Health Commission of New South Wales, which have both recently (and separately) published sets of preferred key indicators.4,5 Repeated Australian reports and reviews suggest mental health services are still best characterised as fragmented,6 bedevilled by major gaps in provision,7 inequitably distributed,8 increasingly costly (…