IngentaConnect Better outcomes in mental healthcare?

Abstract:

Aims The Australian Better Outcomes in Mental Health Care (BOiMHC) initiative strives to achieve better outcomes for people with mental health problems by providing general practitioners (GPs) with training, incentives for delivering structured, quality care, and access to specialists. The initiative has five components, including the Access to Allied Health Services component, which enables GPs to refer consumers to allied health professionals for psychological interventions, via 102 projects conducted through divisions of general practice. In order to assess whether the BOiMHC initiative is in fact achieving better outcomes, outcomes must be measured systematically. This paper explores the current nature and extent of outcome measurement in the Access to Allied Health Services projects.

Methods A brief survey elicited information from divisions on the current and intended use of outcome measures in these projects.

Results Responses were received from 92 projects (90%). Eighty of these (87%) currently use or intend to use an outcome measure, with the most common being the Kessler 10 (78%) and the Depression Anxiety Stress Scales (25%). GPs are involved in administering these measures at assessment and review, although there is a greater reliance on allied health professionals at review. There is considerable potential for aggregating outcome data nationally: in 78% of projects, outcome data are being provided to the division; in 71% outcome data can be linked to an individual consumer (through a unique identifier); and in 80% there is commitment to submitting outcome data to a purpose-designed dataset.

Conclusions Outcome measurement provides a common metric against which to assess the effectiveness (and cost-effectiveness) of projects in terms of impacts for consumers. The time is ripe to introduce routine collation of outcome measures data into these projects, in order to showcase their achievements and provide lessons about their limitations. Implications for others implementing outcome measurement as part of primary mental healthcare reforms are discussed.

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