As demand is increasing, French Mental Health ambulatory settings (CMPs) face an increasing pressure and feel difficulties to achieve their missions (prevention, screening, diagnosis, care and rehabilitation). With the support of a national agency, 8 of them have conducted an 18 month quality improvement project, from April 2006.

In order to have a better understanding of the problems, the first objective was to define what was concretely awaited from them. Based on a study of the literature, operational objectives have been set. Among which, the most notable are: To offer an appointment within 72 hours after the first contact; To offer to all patients leaving the in-patients department, a follow-up consultation within 7 days; To decrease the amount of non attendance…

That definition of objectives made it possible to set up a measurement, to analyse organisational patterns and to launch actions for improvement, such as empowering nurses to allow them to realize the first appointments, reorganizing team working and “institutional times”, defining a strategy to contact non attendant patients…

The use of routine measurement allowed us to evaluate the impact of the project. Actions launched allowed to obtain improvements quickly on some dimensions (for exemple, delay before an appointment with a psychiatrist falling from more than 50 to less than 20 days). Nevertheless other improvements seem longer to achieve (decrease of non attendances).

This report stresses the interest of health services research in achieving significant improvements, regardless of the ideological controversies at stake.