EVALUATIONS OF ORGANIZATIONAL-EFFECTIVENESS IN MENTAL-HEALTH-PROGRAMS

We present a conceptual framework derived from organizational theory f or understanding the evaluation of the effectiveness of mental health services. We postulate that organizations are deemed ''successful'' by their constituents when they conform to institutional demands and exp ectations that are both internally and externally generated We empiric ally assess institutional conformity by examining evaluations of effec tiveness by 269 mental health providers in 29 different mental health programs. Specialist programs responded to institutional demands by ta rgeting services to those considered most in need. clients with severe mental illnesses. The formal structure and program philosophy of thes e programs clearly reflected this emphasis, consequently, levels of go al incongruence were low and evaluations of effectiveness were high. G eneralist programs continued to provide care to diverse client groups, had more professionals, offered traditional services (such as psychot herapy), and exhibited higher levels of goal incongruence, these facto rs resulted in lower evaluations of effectiveness. This research is im portant because if demonstrates that organizational processes of insti tutional conformity (program nm objectives meet the demands of externa l constituents) and goal congruence (program objectives meet with expe ctations of interval constituents) ale critical to positive evaluation s of effectiveness. With the current institutional demand for effectiv e, efficient services, it is critical that researchers have a conceptu al framework for analyzing those factors which influence evaluations o f effectiveness.