Emerging issues in international mental health services research

In developed nations, interest in mental health services research is increasing, which parallels an increased appreciation of the social and financial costs of mental illness and a growing need to identify cost- effective patterns of care. This paper examines common challenges in mental health services research, such as adjudicating between competing mental health priorities, designing research to better understand key elements in successful interventions, defining treatment outcomes more broadly to reflect consumer and family preference and quality of life, and linking services to improve community care. Using the assertive community treatment model as an example, the paper focuses on some of the differences between services research and controlled clinical investigations and the difficulties of looking inside the "black box" of effective interventions.