Clinical update on psychiatric outcome measurement: what is the purpose, what is known and what should be done about it?

Abstract

Objective To provide a clinical update on the purposes, evidence-base and recommendations for both clinician and patient-rated outcome measures in psychiatric practice. Conclusions Private and public sector funders have implemented outcome measurement systems in Australian mental healthcare, in order to improve cost-effectiveness. It is important to consider the ultimate aims of outcome measurement from various perspectives in evaluating the evidence-base, as there are a number of measurement dimensions to address. For individual clinicians, the purpose may be to guide treatment-planning, as well as to assess treatment and clinician efficacy. For patients, the purpose is to assess outcomes in terms of their goals for recovery, as well as to evaluate their satisfaction with the care provided, and their healthcare providers. The other orthogonal dimensions of measurement comprise, the proximal to illness measures of symptomatic severity, and the distal measures of disability, which apply to both clinician and patient outcomes. In turn, these measures may be used by healthcare funders in public or private sectors as proxy measures of the cost-effectiveness of psychiatric care provided. Clinical registries linked to service-mapping would provide better data for patients, providers and funders to assess the availability and effectiveness of psychiatric care in Australia.

Medicare-subsidised mental health services from the beginning of Better Access in 2006–2007 to 2019–2020: Descriptive analysis by state, profession and consultation profile

“…The recently announced Better Access evaluation 6 should be paralleled by consideration of fit-for-purpose general private outpatient measure measurement. 7 Our preliminary overview of private mental health professional services deserves further exploration for improved care.…”

Pilot study of implementing Managing and Adapting Practice in a German psychotherapy master’s program

“…Accordingly, extracting core practices and process models (e.g., overlapping practice elements) of various evidence-based interventions 15 , 16 enables one to scale up EBP by enabling practitioners to engage in a harmonized, transdiagnostic, responsive approach to evidence-based intervention, with a manageable amount of workforce development activity that can be paced over time 17 , 18 . Moreover, this individualized approach addresses the frequently discussed challenge that EBP are not suitable to a range of patients, especially in case of comorbidity, resulting in low response rates 11 , 19 . Individualized approaches are characterized by tailoring and adapting psychotherapy to specific patient characteristics and situations in addition to their disorders in order to enhance treatment effectiveness 20 .…”