quality of mental health care services needs to include not just the quality of specialist services but also quality of primary care services and quality of services supplied by other sectors for example housing or employment services however there is often an inability to avoid choosing indicators for quality benchmarking that reflect the data source that is available rather than optimal measures of quality of care which has perpetuated reliance on inpatient orientated indicators rather than reflecting the shift in the care delivery patterns it is crucial that once optimal quality measures have been agreed upon there is a commitment to work towards collecting these data the establishment of registers and regular assessment of people with smi in primary care can help to reduce the burden of physical illness and improve the quality of care holt et al