Where mental health administrators used to rely on subjective judgments of senior clinicians to evaluate the effectiveness of mental health services, they now rely more on a quality assurance (QA) plan. The primary motive for undertaking a QA program should be better service. QA may start out being very expensive in terms of personnel and programming, but it will eventually result in savings for the facility. Efforts must be made to gain the commitment of staff, management, and board members because QA may uncover problems which are personally threatening but which must be resolved. The understanding that problems discovered will not be reasons for firing of staff is especially important. Quality assurance starts with writing a professional services plan and answering basic questions about the organization. As the last part of the professional services plan, QA ties the disparate operations together by monitoring, identifying problems, and offering solutions. The QA plan itself can be formulated by comparing the elements of the Joint Commission on Accreditation of Healthcare Organizations model plan to the same elements at the reviewed facility. Six basic QA activities guide an evaluation of the facility's functioning: clinical privileging, utilization review, individual case review, program evaluation, staff development, and patient care audit. (ABL)