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The CAHPS^® Experience of Care & Health Outcomes (ECHO) Survey is the product of nearly 6 years of research and testing by CAHPS grantees at the Harvard Medical School, with extensive input from behavioral health care experts and consumers. The survey merges the best aspects of two existing consumer surveys regarding care for mental health and substance abuse issues:

• The Mental Health Statistics Program's Consumer Survey (MHSIP)
• The Consumer Assessment of Behavioral Health Services (CABHS) instrument

The idea was to create a single, standardized survey that would capture as many unique aspects of services as possible while limiting redundancy across survey items.

Contributors to the ECHO Survey's Development

Input into the ECHO Survey came from behavioral health consumers, clinicians, and policy experts, including representatives from:

• The CAHPS Consortium.
• The National Committee for Quality Assurance (NCQA).
• NCQA's Behavioral Health Measurement Advisory Panel (BHMAP).
• The Human Services Research Institute.
• The Center for Mental Health Services.
• The Washington Circle Group.
• The American Managed Behavioral Health Care Association.
• The National Alliance for the Mentally Ill.
• The development team for the MHSIP survey.

Behavioral health care consumers played an especially important role in the development of the survey, providing feedback throughout the development process about the content and design of the instrument. They shaped the survey through their participation in questionnaires, focus groups, and cognitive interviews, and as members of the ECHO Survey's Development Team.

Further Reading

Visit the CAHPS Bibliography for articles about patient experience with behavioral health.

For a detailed discussion of the development of the ECHO Survey, please read:

Daniels AS, Shaul JA, Greenburg P, Cleary, PD. "The Experience of Care and Health Outcomes Survey (ECHO): A consumer survey to collect ratings of behavioral health care treatment, outcomes and plans." In: The Use of Psychological Testing For Treatment Planning and Outcomes Assessment (3rd ed.). Vol. III. Adult Assessment Instrumentation, edited by ME Maruish. Fairfax, VA: Lawrence Erlbaum Assoc., 2004.