Evaluation and Program Planniny, Vol. 19. No. 2, pp. 121-129, 1996 Cmvrieht CC: 1996 Elsevier Science Ltd Pergamon SO149-7189(96)00003-l Printed’& GreatBrttain. All rights reserved 0149-71X9/96 %15.00+0.00 METHODOLOGY FOR EVALUATING MENTAL HEALTH CASE MANAGEMENT DEBORAH M. BRYANT Department of Pediatrics, Vanderbilt University School of Medicine LEONARD BICKMAN Center for Mental Health Policy, Vanderbilt Institute for Public Policy Studies ABSTRACT The evaluation methodology outlined in this paper produces a detailed description of the structure and process of a case management system. Using a theory-based model, a checklist has been developed to describe the attributes of a high-quality case management system, incorporating multiple valueframes. Items on the list describe proximal outcomes logically necessary for effective case management as identiJied by various stakeholder groups. Copyright 0 1996 Elsevier Science Ltd INTRODUCTION Mental health case management services, promoted as the “backbone of the system of care” (Stroul & Fried- man, 1986, p. 21), are required by federal legislation’ for individuals with chronic mental illness (Robinson & Toff-Bergman, 1989). According to Weil (1985a, p. 324), “the essence of case management is the effective integration of services to meet clients’ needs”. However, case management has been likened to a Rorschach test (Schwartz, Goldman, & Churgin, 1982); interpretation of the concept depends greatly upon individual perspec- tive. Even when legislative mandates require case man- agement, the states have considerable latitude in defining it (Burns, Gwaltney, & Bishop, 1995). The heterogeneity of case management programs and the frequent failure of authors to describe case man- agement make it difficult to interpret evidence of its effectiveness. Brekke and Test (1992) noted that an explicit description is needed to determine if services are delivered as planned, to facilitate replication, to study the “critical ingredients” of a model, and to compare varying program models. Clark, Landis, and Fisher (1990) called for investigations to “confirm successful implementation of a case management system before studies of impact are pursued” (p. 228). This paper describes the methodological principles underlying a study of the implementation and quality of case management services in the Fort Bragg Child and Adolescent Mental Health Demonstration Project The authors wish to acknowledge the following people for their assistance in the execution of this study: the staff of the Fort Bragg Evaluation Project who participated in all aspects of data collection and analysis, the staff at Major General James H. Rumbaugh Child and Adolescent Mental Health Clinic, Roy Haberkern, M.D., and the children and their parents who participated in the Fort Bragg Project and shared much about their lives. This research was supported by the U.S. Army Health Services Command (DADAlO-89-C-0013) as a subcontract from the North Carolina Department of Human Resources/Division of Mental Health, Developmental Disabilities and Substance Abuse Services, and a grant to Leonard Bickman (ROIMH-46136-01) from the National Institute of Mental Health. It was also supported by a training grant to Bickman from the National Institute of Mental health (T32MH19544). For reprints or more information, contact Dr Bryant at Division of Community Pediatrics, Vanderbilt University School of Medicine, Nashville. TN 37232-2570, U.S.A. ’ P.L. 99-660 and P.L. 102-231. 121