A 1998 article that measured quality of care for outpatient treatment of schizophrenia listed the following as measures of quality of care
‘We randomly sampled 224 patients in treatment for schizophrenia at 2 public mental health clinics. Appropriate medication management was defined according to criteria derived from national treatment recommendations, and focused on recent management of symptoms and side effects. Adequate psychosocial care was defined as the recent provision of case management or family management to patients for whom it is indicated. Care was evaluated using patient interviews and medical records abstractions.’
In the article income of patients was mentioned. VA patients had an income of $1109 a month and community care patients had an income of $643 a month. One dollar in 1998 is worth $1.60 today. So in today’s dollars VA patients were living on $1774 a month ($22,288 a year) while community care patients were living on $1028 a month ($12,336 a year). Abysmal income levels of patients were not considered as having any impact on quality of care. Given dollars are in short supply and have to be divvied up shifting dollars to patients, increasing incomes of patients, and shifting dollars away from mental health clinics is a sensible way to go.