Patients at Gateway Psychiatric are sometimes perplexed by the amount of time and energy we devote to tracking how they are doing. It can seem annoying to answer questions repeatedly or to fill out forms.
An article in the journal Psychiatric Services summarizes the data that shows that this process (known as “measurement based care” or MBC) is associated with significantly improved outcomes.
More recently, a series of articles in the Journal of Clinical Psychiatry make the same point, including a very poignant video clip of a patient stuck in a chronic depression because no one was paying attention…
Our own experience is that using standardized instruments to measure symptoms and functioning over time helps to identify areas that need further work, and also helps to recognize the significant improvements that are the result of treatment. It supports the creation of a realistic basis for the collaborative work that is at the heart of psychiatric care.
For example, a patient who is continuing to wrestle with depressive symptoms might feel that “treatment is not working” and suggest that there is no point in continuing in therapy or continuing to take medications. When we review the data it becomes clear that she is doing much better in terms of anxiety and depression than when she first came in for treatment, while, at the same time, her sleep continues to be a problem. Without this objective data collected over time it would be easy for the conversation to veer off in a non-productive direction: “You are feeling better…””No I am not.” By accessing the data and looking at it together we can focus on what needs further work.
The authors write that:
“The time is long overdue for the field of mental health to embrace MBC and live up to the medical testing and treat-to-target principles applied by other medical specialties. The cost of routinely administering symptom severity scales is minimal, yet the benefits of MBC accrue to all the stakeholders involved, including patients, providers, purchasers, and payers.”
In an article summarizing this study in Psychiatric News, Lori Raney, chair of the APA Work Group on Integrated Care says that, “Measurement-based care is at the heart of the collaborative care model and advances the ability of clinicians to provide robust treatment for patients. Measurement-based care is ‘absolutely necessary for reporting outcomes to payers in the changing health care environment where value-based purchasing is the wave of the future,'”
For More Information
Psychiatric Services 0 0:0 2016