Monitoring the Quality of Your Mental Health Component

An introduction to the topic from Teresa Huizar, Executive Director, National Children's Alliance.

Key Points for CAC Directors to Know

Why is It Important to Measure Quality?

As the leader responsible for your CAC, it is not enough to “check off the box” and say you have a mental health program. We have learned just how devastating the long term consequences of serious maltreatment are, and we must ensure that the mental health services we offer are as effective as possible. It is a great shame if we squander the opportunity to help a child heal and better his or her life trajectory by wasting the child’s time with ineffective interventions. Even CAC Directors without a mental health background can establish a system to monitor the quality of services delivered in the name of the CAC.

What are the Ways We Can Measure Quality?

The Quality of the Mental Health services can be measured in several different ways. First, you must ensure the basic components of a quality mental health program are consistently in place. These include hiring practices, consistent ongoing training, reasonable caseloads, consistent and ongoing supervision, and so forth. Second, the most direct way to monitor quality, whether delivered directly by the CAC or through MOU with community mental health provider, is to measure clinical outcomes. To do so, the mental health provider must effectively incorporate standardized clinical measures into their practice establishing a clinical base line and then repeat selected measures at preselected intervals to gage clinical progress. Also, the CAC director can establish a “Utilization and Review” system with a well-trained clinical supervisor or consultant who can review a sample of cases against predetermined quality criteria. Lastly, the CAC directors can work with clinical staff to agree on key metrics that are critical elements of quality and track those on all cases.  The data then needs to be complied for management monitoring.

How Can CACs Use Metrics to Monitor Quality?

There are a number of metrics that are relevant to monitoring quality. While few metrics cann guarantee quality as well as outcome measures, they are critical variables that a quality program must have to be effective.  Examples of this approach would be to focus on metrics related to client engagement and satisfaction with services. These includes the percent of children who attend the first session, number of sessions attended, no/show or cancellation rates, treatment completion, customer satisfaction, and stakeholder satisfaction.


How Can CACs Use Conversation to Monitor Quality?

The CAC director can monitor key quality indicators through routine conversations with clinical leaders and therapists.  These conversations can be guided by opening questions focusing on how we assess children and families and match their needs to specific therapeutic interventions. Look for how the therapist integrates the results of the individualized assessment and the child and families perceptions in establishing measurable goals suited to the child’s unique circumstances. We have to pay attention to the therapeutic models we employ and look for empirically-validated models. Evidence-based practices often are structured and directive and focused on specific goals for each session. You should expect active parent
or caregiver involvement in a quality mental health program, although the specific participation will vary depending on the age of the child and presenting concerns. It is also important to assess the role that psychotropic medications play in therapy and who is providing them. Lastly, any time there is more than one therapist on the team, we must look for consistency among providers.



Questions and Answers

Q: How do You Know If You're Offering Quality Mental Health Services?

Dr. Carole Swiecicki, Executive Director of the Dee Norton Lowcounty Children’s Center, discusses providing quality mental health services. 



Length of the video - 0 minute and 40 seconds

Q: What Questions Would You Ask a Director to Determine If What is in Place is Providing Adequate Care and Treatment?

Dr. Carole Swiecicki, Executive Director of the Dee Norton Lowcounty Children’s Center, identifies questions to ask directors regarding providing adequate care and treatment.


Length of the video - 1 minute and 32 seconds

Q: What Are Some Red Flags that Evidence-Based Treatments are not Implemented Correctly?

Dr. Carole Swiecicki, Executive Director of the Dee Norton Lowcounty Children’s Center, describes what to look in providing EBTs.



Length of the video - 0 minute and 49 seconds

Q: How do You Recruit Qualified Therapists Trained in Evidence-Based Treatments?

Dr. Carole Swiecicki, Executive Director of the Dee Norton Lowcounty Children’s Center, discusses ways to recruit qualitied therapists.



Length of the video - 2 minute and 05 seconds


Additional Resources

Click here to download a printable summary of the information on this page. The Trauma Assessment Pathway describes a assessment based therapeutic approach to outcome measurement SAMHSA guidelines on Behavioral Health Outcomes