Why can't mental health services be more like modern baseball?

I am not much of a sports fan but I enjoyed the 2011 movie Moneyball, starring Brad Pitt. The movie is a true story based a book by Michael Lewis, published in 2003, Moneyball: The Art of Winning an Unfair Game (Lewis, 2003). It is about the Oakland Athletics baseball team and its general manager Billy Beane. For those of you who have not seen the movie or read the book I will quote from Wikipedia. ‘‘Its focus is the team’s analytical, evidencebased, sabermetric approach to assembling a competitive baseball team, despite Oakland’s disadvantaged revenue situation... The central premise of Moneyball is that the collected wisdom of baseball insiders (including players, managers, coaches, scouts, and the front office) over the past century is subjective and often flawed. Statistics ... typically used to gauge players, are relics of a 19th century view of the game ... Rigorous statistical analysis had demonstrated that on-base percentage and slugging percentage are better indicators ...These observations often flew in the face of conventional baseball wisdom and the beliefs of many baseball scouts and executives... Moneyball has made such an impact in professional baseball that the term itself has entered the lexicon of baseball... the impact of Moneyball upon major league front offices is undeniable...’’ (Moneyball (film), 2011). The most dramatic scene in the movie for me is when Beane confronts a room filled with the veteran scouts who were making recommendations about which players to recruit. Bean told the scouts they were using the wrong criteria for the last century to select players. ‘‘The team’s scouts are first dismissive of and then hostile... Despite vehement objections from the scouts, Beane ...hires the players he selected. Ultimately, the Athletics win an unprecedented 20 consecutive games, setting the American League record (Moneyball, 2011)’’. Moreover, this was a sustained effect. The A’s made the playoffs five times over a period of 7 years while having one of the lowest payrolls in a league typically dominated by teams with the highest payrolls. Of course professional baseball is not the only sport that has extensive statistics, ask almost any 12-year-old child to cite statistics about his or her favorite sport. Clearly, the statistics are derived from abundant data. What widespread measures do we have in mental health? Probably the most frequent measure is location i.e., inpatient, outpatient, residential etc. Some believe that location tells us something about the type of treatment a client may have received. I believe it tells us about location, period. The price of the service is also frequently recorded, not to be confused with cost. Typically, there may be a date of service recorded. So we have a location, a date and a price. I would hazard a guess that you would not buy a used car with that amount of information, yet that is how we most often describe and sell mental health services. Clearly, there is not much to learn from these measures. We can produce some statistics but they are vastly impoverished compared to what we know about the sport of baseball. Another interesting difference between professional baseball and mental health services is how we pay the practitioners. Economists have studied factors that influence professional sports salaries and concluded that a large percentage is based on the individual performance of the player. Moreover, the relationship between pay and experience is curvilinear with pay being highest in the ‘‘midlife’’ and lower at the start and end of a career (Hakes & Turner, 2011). In contrast the little data I could find on pay for clinicians comes from the American Psychology L. Bickman (&) Vanderbilt University, Nashville, TN, USA e-mail: leonard.bickman@vanderbilt.edu