Make sure you have tried out version 2.0 of the SpeechWriter system from Voice Input Technologies. This is the only continuous speech recognition system available on the market today for mental health professionals. The only other two continuous speech (discrete speech systems aren't even worth a look, in my opinion) systems available are a radiology context from IBM (plans for other contexts are unclear at this time) and the system from Dragon Systems (which is simply a general context; it is unknown how well such a general system would do with the psychological and psychiatric vocabulary, including all those medication names).
Professionals who attend the Connected Computer symposium this summer on Cape Cod will be able to try out the SpeechWriter system for themselves. Out-of-the-box recognition rates (without any initial training) are now in the range of 75-85%. With training, that number easily approaches 95%.
The drawback? It's expensive technology in its current form.
John Grohol, Psy.D.
(Writing here in my role as director of online media development for CMHC Systems, VIT's parent company)