The use of patient-level outcomes to inform treatment

2002 ◽  
Vol 11 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Mike Slade
Keyword(s):  
Mental Health ◽  
Health Care ◽  
North America ◽  
Health Services ◽  
Outcome Assessment ◽  
Clinical Care ◽  
Outcome Data ◽  
Patient Level ◽  
Routine Outcome Assessment

SummaryObjective – The assessment of outcome for any purpose is not undertaken routinely in European mental health services. This paper discusses the merits of using outcome data to inform the planning of mental health care for individual patients, and provides practical advice to support the implementation of this new approach to working. Method – The use of outcomes in North America and Europe is briefly reviewed. A conceptual basis is proposed for routine outcome assessment – the ongoing measurement and use of outcome data to inform decisions about whether to continue, change or curtail treatment. A cognitive psychology model is developed which indicates that the routine use of outcomes will improve mental health care. Perceived problems with routine outcome assessment are discussed, and principles for implementation are identified. Results – Outcomes are used mainly for generating local-level (rather than patient-level) data in North America, and rarely used in Europe. The use of outcome data routinely may facilitate reflective clinical practice, a model of decision-making which leads to a higher quality of clinical care than automated problem-solving. One issue relates to the use of standardised assessments designed for research purposes in clinical settings, and this is being addressed through the development of a new generation of outcome measures which are explicitly designed for clinical use. However, most clinicians remain unconvinced of the benefits of routine outcome assessment, and relevant research is currently underway across Europe which will address this concern. Scientific principles to maximise quality and pragmatic principles to maximise the chances of successful implementation are identified. Conclusions – The routine use of outcomes will become increasingly prominent in European mental health services. This provides clinicians with an opportunity to improve the quality of clinical care offered to patients.

scholarly journals Routine outcome assessment in mental health services

2002 ◽  
Vol 32 (8) ◽  
pp. 1339-1343 ◽  
Author(s):  
MIKE SLADE
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Care ◽  
Outcome Data ◽  
Social Variables ◽  
The United Kingdom ◽  
Slow Decline ◽  
Routine Outcome Assessment

Measuring and interpreting outcome is more difficult in mental health services than in some other areas of health care, for at least five reasons. First, the effect of the treatment may be to slow decline or to maintain the current level, so the score on the outcome measure itself may not improve (or may even get worse) despite best quality clinical care. Secondly, the best available evidence in the United Kingdom indicates that clinical and social variables predict no more than 30% of the variance in an individual's quality of life (UK700 Group, 1999). Thirdly, different types of outcome are desynchronous (e.g. Drury et al. 1996), changing at different rates during an intervention. Fourthly, there may not be agreement regarding what is a positive change in outcome – the patient who has fewer episodes of mania as a result of treatment may see this as a negative outcome. Finally, three levels of mental health service can be differentiated: treatment (specific interventions); programme (combination of different treatment components); and system (all programmes for a defined target group in a given area) (Burns & Priebe, 1996). The outcome data needed to evaluate each level will be very different.

What Outcomes to Measure in Routine Mental Health Services, and How to Assess Them: A Systematic Review

2002 ◽  
Vol 36 (6) ◽  
pp. 743-753 ◽  
Author(s):  
Mike Slade
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Assessment ◽  
Full Range ◽  
Step Method ◽  
Adult Mental Health ◽  
Patient Level ◽  
Routine Outcome Assessment

Objective: Routine outcome assessment in adult mental health services involves the ongoing assessment of patient-level outcomes. Use of outcomes to inform treatment is widely recommended, but seldom implemented. The goals of this review were (i) to identify principles that have been proposed for implementing routine outcome assessment, (ii) to identify the full range of outcome domains that have been proposed for assessment, and (iii) to synthesize proposals for specific outcome domains into emergent categories. Method: A systematic review of published and unpublished research was undertaken, using electronic databases, research registers, conference proceedings, expert informants and the World Wide Web. For goal (i) studies were included that proposed principles for implementing routine outcome assessment. For goal (ii) studies were included that identified at least two patient-level outcome domains for patients using adult mental health services and made some reference to a broader literature base. Results: Six thousand four hundred publications matched initial search criteria. Seven distinct sets of principles for choosing patient-level outcomes were located, which showed a fair degree of consensus. Sixteen outcome domain proposals were identified, which were synthesized into seven emergent categories: wellbeing, cognition/emotion, behaviour, physical health, interpersonal, society and services. Conclusions: The findings from this review were used to develop a four-step method for adult mental health services wishing to implement routine outcome assessment.

Guidelines for Adapting Mindfulness-Based School Interventions with Underserved Youth

2021 ◽  
Author(s):  
Mary Lynd Phan ◽  
Tyler L Renshaw
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Disparities ◽  
Quality Of Care ◽  
Health Services ◽  
Social Emotional ◽  
Emotional Competencies ◽  
Underserved Youth ◽  
Diverse Youth

Low-income and ethnically diverse youth in the United States have unmet needs for mental health services; however, these same youth are unlikely to be connected with high-quality mental health care. Promoting social-emotional competencies through school-based service delivery is one potential solution for improving the accessibility and quality of care for diverse youth facing mental health disparities. Mindfulness, conceived as a set of practices to cultivate social-emotional competencies, can therefore be useful for improving the accessibility and quality of care for diverse youth facing mental health disparities. Given the growing interest in MBSIs and the need to enhance equity in youth mental health services more generally, we provide guidelines to help practicing clinicians successfully adapt and implement MBSIs with underserved youth. First, we offer recommendations for clinicians to enhance underserved youths’ engagement with MBSIs. Next, we overview implementation approaches that clinicians could use for increasing access to MBIs in school settings. Following, we discuss strategies clinicians might employ when working with teachers to effectively implement MBSIs with underserved youth in their classrooms. Ultimately, we hope the guidelines offered in this paper might help inform better practice—as well as motivate further, better research—that advances equitable mental health care in schools with underserved youth.

scholarly journals Evaluating mental health services. A world perspective

1997 ◽  
Vol 6 (S1) ◽  
pp. 239-245
Author(s):  
Norman Sartorius
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
World Wide ◽  
List Type ◽  
Type Number ◽  
Evaluative Research ◽  
World Perspective

Evaluations of mental health services are much in demand. Their results are supposed to help in improving the quality of mental health care and in making them economically better viable.Yet, world-wide there is: 1)little agreement about the content of terms such as evaluation, mental health service, outcome of an activity although these and other terms are widely used;2)uncertainty about the best use of results of evaluative research;3)lack of consensus about who should evaluate what and by what method.

scholarly journals Is it time to use checklists in mental health care auditing?

2011 ◽  
Vol 3 (1) ◽  
pp. 33-35
Author(s):  
Moshe Z. Abramowitz ◽  
Jacob Polackiewicz ◽  
Alexander Grinshpoon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Health Services ◽  
Mental Health Care ◽  
Comprehensive System ◽  
Design And Implementation ◽  
Potential Risks ◽  
On Site Inspection

A key strategy for improving the quality of mental health care is the design and implementation of a mechanism for on-site inspection and clinical auditing. We discuss the use of checklists in auditing providing an objective, comprehensive system for recording and analyzing multi-disciplinary, clinical auditing in mental health services. We believe such an approach can identify potential risks and allow for better decision making.

Quality development in mental health care in Europe. Recent contributions by WHO

1997 ◽  
Vol 6 (S1) ◽  
pp. 211-215
Author(s):  
José G. Sampaio Faria
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Of Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
European Region ◽  
Quality Development

In 1984 all Member States of the European Region agreed on a Pan European Health Policy, popularly known as Targets for Health for All (Health for all targets, 1991).Among the 38 targets agreed, Target 31 states (table I).More recently the first meeting of national directors/officials of mental health services in the European Member States stated that “there should be greater concern about the quality of mental health care in each Member State, and mechanisms must be established to guarantee a quality service. These include: a.encouraging mental health care professionals to develop systems to monitor the quality of care;b.independent inspection of services;c.the participation of consumers and relatives;d.improving the basic and continuing training of mental health professionals as well as their working conditions;Special attention should be paid to the quality of care provided to those with severe long-term mental disorder, the elderly, children and adolescents. Barriers to care should be avoided, particularly for people with long-term mental disabilities.”The need for quality development and evaluation differ quite significantly across the European Region as a result of the existing differences in the pattern of mental health services and priority policies to be implemented.

scholarly journals Improving the quality of mental health services using patient outcome data: Making the most of HoNOS

2017 ◽  
Vol 41 (3) ◽  
pp. 172-176 ◽  
Author(s):  
Mike J. Crawford ◽  
Mo Zoha ◽  
Alastair J. D. Macdonald ◽  
David Kingdon
Keyword(s):  
Mental Health ◽  
Patient Outcome ◽  
Quality Of Care ◽  
Mental Health Services ◽  
Health Services ◽  
Patient Outcomes ◽  
Outcome Data ◽  
Lack Of Information

SummaryEfforts to assess and improve the quality of mental health services are often hampered by a lack of information on patient outcomes. Most mental health services in England have been routinely collecting Health of the Nation Outcome Scales (HoNOS) data for some time. In this article we illustrate how clinical teams have used HoNOS data to identify areas where performance could be improved. HoNOS data have the potential to give clinical teams the information they need to assess the quality of care they deliver, as well as develop and test initiatives aimed at improving the services they provide.

[P1-509]: IMPROVING THE QUALITY OF MENTAL HEALTH CARE OFFERED TO DEMENTIA PATIENTS AND THEIR FAMILIES THROUGH CO-LOCATED MEDICAL AND MENTAL HEALTH SERVICES

2017 ◽  
Vol 13 (7S_Part_9) ◽  
pp. P488-P488
Author(s):  
Alyssa S. Botte ◽  
Kathryn Johanson ◽  
Kaycee M. Sink ◽  
Christina E. Hugenschmidt ◽  
Cathy C. Wilson ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Dementia Patients

Reflections on Clinician Leadership and Management in Mental Health

2005 ◽  
Vol 13 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Tom Callaly ◽  
Harry Minas
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Care ◽  
Essential Element ◽  
Leadership And Management ◽  
Clear Vision ◽  
Psychiatric Profession

Objective: To review the role of clinician leadership in the management of mental health services. Conclusions: The literature suggests that clinician leadership is increasingly regarded as an essential element in the effective introduction of innovation and improved quality of clinical care by those who manage mental health services. Psychiatrist leaders have a role to play in ensuring that service change and innovation is based on sound clinical values, is developed in partnership with clinicians and is understood and supported by psychiatrist colleagues. Clinician leaders require clear vision, commitment and courage. The support of their colleagues is essential if the psychiatric profession is to have influence on future development of mental health services.

Guidelines for Adapting Mindfulness-Based School Interventions with Underserved Youth

2021 ◽  
Author(s):  
Mary Lynd Phan ◽  
Tyler L Renshaw
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Disparities ◽  
Quality Of Care ◽  
Health Services ◽  
Social Emotional ◽  
Emotional Competencies ◽  
Underserved Youth ◽  
Diverse Youth

Low-income and ethnically diverse youth in the United States have unmet needs for mental health services; however, these same youth are unlikely to be connected with high-quality mental health care. Promoting social-emotional competencies through school-based service delivery is one potential solution for improving the accessibility and quality of care for diverse youth facing mental health disparities. Mindfulness, conceived as a set of practices to cultivate social-emotional competencies, can therefore be useful for improving the accessibility and quality of care for diverse youth facing mental health disparities. Given the growing interest in MBSIs and the need to enhance equity in youth mental health services more generally, we provide guidelines to help practicing clinicians successfully adapt and implement MBSIs with underserved youth. First, we offer recommendations for clinicians to enhance underserved youths’ engagement with MBSIs. Next, we overview implementation approaches that clinicians could use for increasing access to MBIs in school settings. Following, we discuss strategies clinicians might employ when working with teachers to effectively implement MBSIs with underserved youth in their classrooms. Ultimately, we hope the guidelines offered in this paper might help inform better practice—as well as motivate further, better research—that advances equitable mental health care in schools with underserved youth.

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