What Is Necessary To Transform The Quality Of Mental Health Care

Abstract

Improving the quality of care is a national priority in the United States; however, it is not clear how to accelerate progress for mental health care. We recommend advances in three capacities: (1) developing quality improvement resources applicable to a diverse set of mental health disorders, clients, and service settings; (2) improving the infrastructure for providing evidence-based psychotherapy and psychosocial interventions; and (3) promoting innovation in financial incentives for quality improvement in mental health care. We also discuss the need to develop leadership among health care stakeholders and community engagement to promote public commitment to high-quality care in mental health. [Health Affairs 25, no. 3 (2006) e c e n t p o l i c y an d r e s e a r c h i n i t i at i v e s have drawn widespread attention to gaps in the quality of care. Low or moderate rates of use for appropriate treatments and preventive services have been found across a wide range of health conditions, including common mental disorders.1 Improving the quality of mental health care is an important priority, because mental disorders are major contributors to the total global burden of illness and have been identified as priority conditions for tracking the overall performance of the U.S. health care system. 2 Despite this, major barriers to improving the quality of mental health care remain. In a recent report on the state of quality measurement in medical practice, only 4 of 179 quality indicators were related to mental health care.3 Efforts to include mental health in broader quality improvement initiatives face such barriers as condition-and treatment-related social stigma and regulations concerning privacy. These barriers are often exacerbated by system factors specific to mental health, such as the broad array of provider specialty types and agencies providing

Who Comes Back? Characteristics and Predictors of Return to Emergency Department Services for Pediatric Mental Health Care

“…The mental health system, however, has been chronically underfunded, has limited service options, and has a continued need for specialty-trained personnel. 2 Longstanding reports that as few as one in six children and adolescents receive timely and necessary mental health services, or that seven of 10 adolescents with mental health needs receive no care, 1,[5][6][7][8] have had limited impact on multilevel system changes, [9][10][11][12][13][14][15] and service shortage persists. 9,10,13,[16][17][18][19][20] In times of acute crisis, emergency departments (EDs) have become a key system entry point for children and adolescents in need of unscheduled mental health care [21][22][23][24][25][26] and are considered a ''safety net'' 12 for the lack of inpatient and outpatient mental health services.…”

Understanding the Goals of Service Learning and Community-Based Medical Education: A Systematic Review

“…Increased community engagement and reciprocal knowledge transfer could prepare medical students to practice in the rapidly changing health care environment-one that now includes an important new agenda of community accountability. 77 …”

Towards the Mental Health Ontology

“…as well as information and computer scientists to come together and build intelligent systems to aid medical researchers, physicians, patients and general public in efficient and effective use, management and retrieval of mental health information. Such systems go some way to delivering what Patel et al [49] say is 'necessary to transform the quality of mental health care'. They improve the infrastructure for evidence-based interventions and provide innovation for quality improvement in mental health care.…”