A great complaint about the mental health system-voiced not only by the New Freedom Commission but also by many advocates and other clinicians-is its failure to bring interventions and services of known effectiveness into common practice. While this "science to service" lag is not unknown in general health care, its effect in mental health seems particularly pronounced, perhaps because so much has been learned about the delivery of effective mental health services in the past quarter century.

The Surgeon General, the President's Commission, and most other experts have encouraged more consistent use of evidence-based practices in the mental health field. At the same time, many practitioners note that innovation in the field has been critical to many advances that only now are demonstrating support in rigorously designed studies. Since scientifically validated services do not exist for every condition, providers should be encouraged to think systematically about what known interventions provide the best outcomes for each individual. Policymakers and consumers should demand that mental health care demonstrate a connection between practice and science-programs or policies should adhere to "practice-based evidence" in which the experience of consumers and clinicians is systematically monitored and considered with respect to the process and outcome of a particular treatment or service. In many settings, however, the problem remains one of reluctance to embrace new practices of any sort, whether supported by scientific study or merely by the enthusiasm of creative practitioners.

Policymakers should ensure that practitioners employ effective mechanisms for dissemination of findings regarding promising practices and evidence-based practices in the systems they oversee. These mechanisms might include conferences, professional journals, academic partnerships, and regular in-service training opportunities. Contracts and grant awards should include bonuses or other incentives for the use of evidence-based practices as well as for training and other dissemination practices. Some state public mental health systems are accepting the challenge and taking steps to bridge the gap between research and practice. The Ohio Department of Mental Health, for example, has established "coordinating centers of excellence" responsible for disseminating evidence-based or promising practices across the state. In Illinois, funding from the state Office of Mental Health has helped to establish the Illinois Staff Training Institute for Psychiatric Rehabilitation at the University of Chicago.

Just as not all practices have an evidence base, not all evidence-based practices will have equal relevance to all mental health consumers. For that reason, emphasis must be placed on carefully screening and assessing individuals to ensure that they are connected with appropriate care strategies. (See Policy Statement 8, Intake, for a discussion of how these processes should be applied in the correctional setting.) Through appropriate assessment and apprehension of current evidence-based practice, mental health care providers can effectively match their practice to consumers' needs. Promising trauma-based interventions, for example, can be made available to those whom research shows would be most likely to benefit from them.

Identifying common goals or outcome measures allows the mental health system room to deliver on the expectations of other systems, such as corrections, which in turn facilitates appropriate resource allocation. Policymakers must tie continued support of policies and practices to the development of such outcome measures, to evaluation of programming in accordance with those measures, and to communication from practitioners about progress toward shared goals. (See Policy Statement 6, Measuring Outcomes and Evaluating the Impact of a Re-Entry Initiative, for more on establishing performance measures and other program assessment techniques.)