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This study evaluated the possible effects of peer, unit staff, and quality management staff survey administrators on item means of the inpatient version of the Consumer Assessment of Care, a 14-item mental health service satisfaction survey developed by the New York State Office of Mental Health and administered at South Beach Psychiatric Center. Of 511 inpatients who completed the survey, 215 were administered by unit staff, 156 by consumers, and 140 by quality management staff. Each subgroup used a mixed-mode administration method for consecutive 6-mo. periods. Reliability and factor analysis indicated the survey was psychometrically robust. Item means for the types of administrator were significantly different. Tukey HSD multiple-comparisons indicated that item means were significantly higher for unit staff administrators than peer and quality management staff administrators, which did not differ from each other. Response set, acquiescence, or socially desirable responding may elicit higher item means for unit staff administrators.

The psychometric properties of the Behavior and Symptom Identification Scale, administered in a crisis residential mental health treatment setting, were investigated. Analyses indicated that Cronbach [alpha] reliabilities were very good compared to published research from inpatient and outpatient settings. Univariate and multivariate covariance analyses provided evidence supporting validity in terms of sensitivity to change during treatment and concurrent validity. Evidence supported the contention that women were more honest and realistic in their self-assessments but also that crisis residence treatment was efficacious for both sexes.

To assess the system's comprehensiveness in provision of public managed mental health care South Beach Psychiatric Center surveyed a sample (n = 54) of its primary therapists employed in its outpatient departments which have recently been reconfigured as key components of the New York State Office of Mental Health Prepaid Mental Health Plan. They are intended to be comprehensive resource and treatment centers which optimize recovery in a deregulated, capitated environment. As key informants, the primary therapists were asked to rate the difficulty they experience in providing or arranging adequate services and support groups in 19 areas. They were also asked to indicate if the fundamental problem was one of access, information, quality, or supply. The five areas with the highest ratings of difficulty were housing or residential services, substance-abuse services, dental care, general health care, and employment or vocational services. The reason for difficulty most endorsed for these areas was supply. It is suggested that capitated managed care contracts can create incentives to increase the supply of such services.