‘What gets measured, gets done’

The Meadows Institute shares the value of measurement-based care.

Speaking at a Nov. 21 webinar on “The Role of State Policy in Driving Behavioral Health Measurement, Quality Improvement and Cost Control” hosted by the Association for Behavioral Health and Wellness and NeuroFlow, Meadows Mental Health Policy Institute Chief Policy Officer John Snook revealed a challenge with mental health treatment in America: “For too long, we have allowed people to get really sick before treatment.”

As an example, Snook pointed to an average delay of six to seven years in the treatment of psychosis, which research tells us leads to worse outcomes.

The truth, said Snook, is that many mental illnesses are pediatric illnesses. “If we don’t start providing care early, we aren’t going to get people better. We have to move upstream.”

Treating everyone with mental illness in specialty care is not realistic, he said, considering the limited resources of our beleaguered mental health care system. The answer, he said, is to treat more people in primary care, via integrated behavioral health models like the psychiatric Collaborative Care Model, which brings together physical and mental health care treatment within a primary care provider’s office.

But collaborative care doesn’t work without measurement-based care (MBC), Snook explained. “It’s a hand-in-glove process.”

MBC is a clinical process that uses standardized, valid, repeated measurements to track a client’s progress over time and to inform treatment. It has been shown to enhance treatment decision-making, detect changes in illness symptoms and severity, result in faster symptom reduction, reduce drop out, and improve outcomes.

“Behavioral health measurement is fundamental to moving us forward,” said Snook. “We have a responsibility and an opportunity to implement behavioral health measurement because we know what gets measured gets done and what gets measured gets people better.”

Stressed Snook: “If I am a state taking mental health seriously, I am implementing MBC to know I am using my money effectively and efficiently.”

Fellow panelist Kathie Snell, chief strategy and operations officer at Aurora Mental Health and Recovery in Colorado, agreed. “The research is clear [that MBC] is the best way for us to be able to provide the kind of care that really impacts not only the clients we are serving but the system as a whole.”

After Aurora decided to comprehensively measure and implement MBC with the use of a digital tool from NeuroFlow, Snell said she and her colleagues were pleased to see results that “mirrored the research outcomes almost exactly”: a 56% faster progress toward remission, fewer no-shows for client services, a 30% increase in capacity because people were getting better faster, and 28% cost reduction through strategic behavioral health measurement.

Snook lauded similar progress in Florida, where the Florida Chamber of Commerce, with the guidance of the Meadows Institute, recently published a strategic plan to make the state a national leader on mental health by integrating primary and specialty care and implementing measurement.

“To have the business community and state government building and incentivizing this system is how you get from a community that knows what they need to do but can’t get there to a community that’s really succeeding,” said Snook.

As the online seminar ended, moderator and NeuroFlow Chief Commercial Officer Robert Capobianco asked the panelists what the first step is for physicians and health systems considering whether to implement MBC.

Snook said the first step is to explain MBC’s intrinsic value, how it benefits the entirety of the system. “We are seeing success in all age brackets. Youth, older adults, and those populations that we’re really worried about from a broader social perspective are able to be helped by these programs.”

Added Snook: “Lots of people want to do the right thing, but when you’re talking about these populations, to be able to say there’s overwhelming evidence that these sorts of initiatives can save you money and get better outcomes, helps start the conversation.” Watch the full recording, here.