Developing Quality Measures to Advance Mental Health Care Access and Outcomes

Presenter:

Jennifer Humensky, Ph.D. and Leonardo Cubillos, M.D., M.P.H.

Division:

Division of Services and Interventions Research and Center for Global Mental Health Research

Goal:

This concept aims to support the development, testing, validation, and implementation of measures to advance mental health care access, outcomes, and quality in the United States or other high-income countries, in addition to low-and middle-income countries (LMICs). To facilitate translation of findings into practice, this concept seeks to support the development and validation of measures and data collection that can be reviewed and endorsed by relevant regulatory or governing bodies.

Rationale:

An urgent need exists for validated quality measures to assess, and help incentivize improvements in, access, outcomes, and efficiency of mental health services. Quality measures assess the rate of a target outcome over a group of patients (e.g., the percentage of patients identified with a specific illness or disorder, who achieved a specified level of clinical improvement within a defined amount of time).

While standardized instruments for assessing patient clinical status are plentiful, there is a paucity of mental health-specific quality measures that assess access to care or treatment outcomes. Thus, there is a crucial need to adapt standardized instruments of patients’ clinical status into outcome-focused measures of the quality of mental health care, which can then be endorsed for use in practice by relevant national accrediting and governing bodies, adopted by payers, and in turn used to improve clinical care.

Quality measures can be used by policymakers, payers, organizational leaders, and clinicians to deliver, monitor, and improve care (e.g., to facilitate measurement-based care, evaluate the effectiveness of services, or implement continuous quality improvement initiatives). They can also be used to test and compare the effectiveness of alternate models of service delivery, financing and payment (e.g., assessing comparative- and cost-effectiveness across programs, or evaluating the impact of shifting from traditional fee-for-services to value-based payment models).

This concept aligns with Goal 4 of the NIMH Strategic Plan for Research that calls for the development of valid and reliable measures of access and quality of mental health services that can be feasibly applied at the person, clinic, system, and population levels.  Accordingly, this concept calls for projects that aim to develop, validate, and explicitly seek endorsement of outcomes-focused or access-focused mental health quality measures by national accrediting and governing bodies.