Patient care varies considerably across psychiatric practices, a finding that is particularly relevant for developers of performance indicators and risk-adjustment strategies for mental health.

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Due to increased misbehavior by girls there is a growing need to understand these students. Knowing how behavior-problem girls perceive school is necessary for effective educational programming. To investigate these perceptions, 15 truant junior-high school girls were interviewed in-depth. Their responses were compared to those of 15 nontruant girls and 15 truant boys. The truant girls moderately disliked school and found teachers to be unfair and excessively concerned with minor rules. Consistently, the truant girls showed less negative perceptions and less asocial behavior than the boys. The girls also differed by being more variable in behavior and attitudes. The girls more often than the boys appeared to have personal conflicts which accentuate school problems. It is suggested that schools should view truancy as a coping mechanism for avoiding discomfort in school, and that behavior-problem girls should be dealt with in an individualized manner.

Traditional evaluation of health care quality usually involves the measurement of the structure, process, and outcome of care. Most quality improvement programs involve a cycle that includes a setting of goals, a measurement of either process or outcomes, and a real-time or retrospective feedback of the results of data measurement. Benchmarking, a well-known efficient business technology, can lead to practice innovations necessary to survive in an environment that has a need for decreasing cost and increasing quality. The purpose of this article is to present a novel use of benchmarking in managed ambulatory behavioral health care and its application in a model collaborative outcome management project at more than 16 sites and nine states in the United States.

This case study describes the inclusion of a nonverba~ trained process