The author describes the increasing focus on regulation and the standards applied to the field of mental health. He discusses four distinct but overlapping types of standards: 1) clinical, 2) practitioner, 3) program and facility, and 4) payment. He emphasizes the increasing influence of legislation and judicial decisions and points out several trends in standard setting affecting mental health care. Psychiatrists and other mental health practitioners are called on to take a larger role in shaping these standards to ensure that the quality of patient care is not compromised.