measurement based care behavioral health is the systematic administration of validated self-report measures to monitor health outcomes. It is a foundation of many behavioral health services and a growing practice in both private practices and in large healthcare systems.
Increasingly, regulatory bodies are mandating the use of measurement-based outcomes in both physical and mental health. For example, in the Medicare world, behavioral health providers must screen patients and follow-up on those screenings over time.
These requirements are a big step toward measuring health outcomes. In the mental health space, a lot of the focus is on self-reported outcomes based on symptom rating scales.
There are a few limitations with this type of approach though. First, it is largely focused on self-reported data that is collected prior to clinical encounters and fed back to clinicians during clinical sessions.
Second, these self-reported measures are typically very brief and may reflect only a limited range of the patient’s functioning. This is especially true for the most common behavioral health conditions such as depression or anxiety.
Third, these measures are not often administered on a consistent basis and so are difficult to detect when symptoms are worsening. For instance, in a study of eating disorder patients who completed a self-reported symptom assessment prior to a counseling session and then fed that assessment to their clinician midway through the counseling session, they did not have better outcomes than those who remained on a normal treatment track without this feeding back.
Fourth, these symptom-focused measurements are not necessarily correlated with other indicators of well-being. For example, it is not uncommon to see patients with a number of psychiatric disorders with high levels of social support, yet low levels of sleep or appetite.
Similarly, it is not uncommon to see patients with significant behavioral health conditions with high social support, low sleep and appetite, but poor mental health. This is due to the fact that these psychiatric conditions are often complex and exacerbated by socioeconomic factors.
These limitations mean that a comprehensive approach to measuring mental health and identifying gaps in care needs to be implemented. Fortunately, there are many studies that show the efficacy of measurement-based care in improving patient outcomes.
Evidence-based research has shown that MBC can help improve outcomes in a variety of modalities and populations, including anxiety, depression, substance use disorders, bipolar disorder and eating disorders [1-3]. When compared to usual treatment, MBC increases response rates to treatment, decreases treatment dropout rates, and enhances remission rates.
Measurement based care is a way to measure progress and inform treatment decisions by allowing clinicians and patients to use data that is relevant to the client’s unique situation. It empowers clients to take ownership of their treatment goals and collaborate with clinicians to set actionable objectives. It also helps to reduce relapse and increase treatment retention.