Ethical principles for evaluating mental health services: A critical examination

With the continuing focus on quality in the NHS, a framework is needed for the systematic evaluation of mental health services. Several frameworks are described, including a set of nine ethical principles proposed by Thornicroft & Tansella (1999) for translation into outcome measures. In recognition of the importance of these principles, this paper expands on their definitions and operationalises them by applying them to particular crisis services. It is shown that the principles can be usefully applied to both service planning and evaluation. Different relationships between the principles are identified and it is concluded that a full set of measures is needed for a comprehensive evaluation. The principles are in line with British Government priorities, and overlap with other frameworks for quality and service evaluation, and so a modified set of principles is proposed for further testing.