The importance of measuring the quality of mental health care is widely recognized. A number of factors should be considered when constructing mental health quality indicators including the aspects of care to be measured; translation of quality measurement concepts into indicators that can be measured; pilot-testing, analysis and display of measures; and maintaining effectiveness of performance measures and policies over time. The impetus to measure quality in mental health care may be dampened by the innumerable challenges inherent in this worthwhile endeavour. In particular, many countries lack adequate quality measurement infrastructure. Challenges may be overcome to a certain extent by international collaboration. While cross-country co-operation can also introduce additional complexities; its benefits usually outweigh the costs. Quality indicators can have many uses but of utmost importance is that quality measurement in mental health care subsequently results in quality improvements.