C ontinuity of care (COC) is widely regarded as central to the provision of mental health services. It has recently assumed greater importance in conjunction with the decentralization of service delivery in mental health systems across Europe (1) and North America (2-4). Clinicians commonly assume that, if COC is absent from the services provided to patients with chronic and debilitating conditions, the result may be social isolation, economic hardship, and threats to quality of life. The concept has been characterized by some as a "strategic first choice" in the case of service planning and

There is little evidence that continuity of care results in better client outcomes, which may be primarily attributable to the underdevelopment of measures. Measurement of continuity of care must become more sophisticated before key questions about the association of continuity of care with outcomes can be examined and before the effectiveness of interventions designed to improve continuity of care can be rigorously evaluated.