Mental health, already a significant concern prior to the pandemic, has become an even greater concern over the past two years for people of all ages, including children, and in all walks of life. The ability to provide ongoing help to those suffering with mental or behavioral health issues has become a top priority for clinicians.
Unfortunately, monitoring and measuring progress can be challenging. And even though clinicians support monitoring and measuring progress in mental health treatment, few do so in practice. As an article published in Administration and Policy in Mental Health and Mental Health Services Research notes, “Numerous trials demonstrate that monitoring client progress and using feedback for clinical decision-making enhances treatment outcomes, but available data suggest these practices are rare in clinical settings.”
There is a need for the wider use of objective, outcome-focused progress measures in mental health treatment and measuring mental health outcomes. For some clinicians, this will require shifting from measuring process to measuring outcomes. What does this mean?
Process vs. Outcome Measures
To put it simply, process measures tell us what was done while outcome measures tell us what happened after something was done.
Process measures have historically been relatively easy to document and monitor. One common example: a provider had an appointment with a patient and then prescribed a medication or ordered a test. But these process measures don’t give an indication of the impact of these efforts on the patient’s mental health.
That’s where outcome measures come into play.
Importance of Outcome Measures
Outcome measures focus on improvements in patients’ mental health. They allow clinicians to measure the impact of their treatment decisions and do so over time (i.e., measurement-based care). An example: The percentage of patients adhering to their medication regimen before and after treatment. Such outcome measures help clinicians make data-driven decisions about changes that need to be made or where treatment should be continued or enhanced.
Self-report screeners and assessments can generate much of this data and support efforts to measure progress and wellness. For example, scales like the Sheehan Disability Scale or Sheehan Suicidality Tracking Scale can be used over time to monitor patients’ state-of-mind and can be effective treatment progress indicators. Patient-reported outcome performance measures (PRO-PMs) include pain, functional limitations, energy, and emotional distress.
Both clinicians and patients may track outcome measures. In behavioral health, patient reports are particularly important because it can be difficult for clinicians to actually “see” or observe improvements or identify any decline in mental health.
It’s important to make a distinction between valid, behavioral health improvement-related outcome measures and patient satisfaction. A client may indicate that they’re satisfied with their treatment, and yet an outcome measure — like the number of times the patient has visited the emergency room because of feelings of anxiety — would tell an entirely different story.
Getting Started with the Use of Outcomes-Focused Measures
It can be a bit overwhelming when first getting started with using outcomes-focused measures. There are a wide range of outcome measurement tools for mental health to consider. Fortunately, there are resources available to help you establish a foundation for moving forward with outcomes measures and choosing solutions that can best help you support those with mental illness. The Kennedy Forum, for instance, has published “A Core Set of Outcome Measures for Behavioral Health Across Service Settings.”
Healthcare organizations and their providers need to consider the different types of patients they treat based on specific diagnoses, desired outcomes, and methods of evaluating those desired outcomes through physician and patient reporting. Standardizing this evaluation across patient or client groups can help provide comparative information and identify best practices and opportunities for improvement.
In addition, clinicians can seek input from patients about the types of outcomes they would consider as signs of their own improvement and incorporate these measures into care plans. Involving patients in this process is important and helps them feel a greater sense of responsibility for their own improvement.
Mental health has become a concern for everyone involved in delivering care. Considering how to best measure progress in mental health is a critical element of effective treatment and one that needs to be incorporated throughout the care continuum. Want to learn more about the impact outcome measurement can and should have in mental healthcare? Watch this on-demand webinar.