Abstract
Both evidence-based practices and performance measurment in mental health systems have been implemented as largely independent initiatives, each facing issues related to systemwide, sustained implementation. A major thrust of this article is that a broader quality and accountability framework is crirical for obtaining better outcomes and for incorporating these initiatives into business as usual. This article provides an overview of national initiatives in these areas, lessons learned from implementation efforts, and problems encountered. Building on these experiences, a model for a quality and acountability framework is proposed in which evidence-based practices and performance measurement systems can together provide productive and ongoing synergy.