Aiming for Excellence in Mental Handicap Services

Interest in the quality of services for people with a mental handicap has arisen from three main sources; administrative and financial monitoring, research, and humanitarian concern. Three related concepts are: quality of service, which equates roughly to structure; quality of care, which is a process‐oriented concept concerning the interaction of care staff and clients; and quality of life, which reflects the outcome of service provision and the views of consumers. In a literature review, the author distinguishes two methodological approaches: evaluation, which is a point‐in‐time measure; and monitoring, which is an ongoing process. Research findings on the three dimensions listed above are discussed in the context of these two methods; limitations and confusions are outlined, particularly in accreditation‐based systems. The importance of a total quality approach is stressed, combined with an emphasis on the effects of services on individual mentally handicapped people.