Due to rising costs, the economic aspects of the mental health care sector are receiving increasing attention. This article scrutinizes 91 published studies in the field of mental health care, applying methodological criteria drawn from epidemiology and economics. The purpose of this study is to provide some insight into the quality of economic evaluation in the field of mental health care. The article shows that few good full economic evaluations studies have been undertaken in the domain of mental health care. One reason for this could be that the measurement of effectiveness in mental health care is complicated because of the known difficulties with the reliability of psychiatric diagnosis and the lack of consensus about the etiology and appropriate treatment for many psychiatric illnesses.