Improving Mental Health Care

Written by many of the world's leading practitioners in the delivery of mental health care, this book clearly presents the results of scientific research about care and treatment for people with mental illness in community settings. The book presents clear accounts of what is known, extensively referenced, with critical appraisals of the strength of the evidence and the robustness of the conclusions that can be drawn. Improving Mental Health Care adds to our knowledge of the challenge and the solutions and stands to make a significant contribution to global mental health.

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

The first book to focus on measuring the basic processes of mental healthcare, such as access, detection, treatment appropriateness, safety and continuity of care, Improving Mental Healthcare: A Guide to Measurement-Based Quality Improvement integrates practical information about quality measures -- such as their clinical logic, validity and basis in scientific evidence -- into a highly readable guide on how to implement measures and use the results to improve quality of care. Improving Mental Healthcare examines the clinical, policy, and scientific underpinnings of process measurement, a widely used method of assessing quality of mental healthcare. It describes the use of measurement to improve quality, promote accountability, encourage evidence-based practice, and shape incentives to favor delivery of high-quality care. Divided into two sections totaling 14 chapters, the first section describes factors that led to a nationwide emphasis on improving quality of care, major approaches to quality assessment, considerations in selecting measures, as well as how to analyze and interpret measure results. The second section summarizes information on more than 300 quality measures, including their clinical rationale, specifications, sources of data, supporting evidence, readiness for use, and -- where available -- data on reliability, validity, results, case-mix adjustment, standards, and benchmarks. Improving Mental Healthcare helps clinicians, managers, administrators, payers, purchasers, accreditors, consumer groups, and other stakeholders meet national mandates to assess and improve quality of care by providing the following tools and guidance: Results from the National Inventory of Mental Health Quality Measures, a federally funded study summarizing clinical, technical, and scientific properties of more than 300 process measures A user-friendly format that helps potential measure users find quality measures that reflect their priorities and meet their needs Guidance for healthcare organizations and clinicians on how to integrate measurement into a comprehensive approach to quality management An understanding of the relationship between process measurement and other approaches to quality assessment, in particular outcomes assessment-the focus of a companion guide, Outcome Measurement in Psychiatry: A Critical Review (APPI 2002) Improving Mental Healthcare, which includes extensive references as well as useful figures and tables illustrating key concepts, is essential reading for practicing clinicians, healthcare managers, medical students and psychiatric residents -- who must now meet ACGME requirements to learn about quality assessment and improvement -- as well as members of oversight organizations and consumer advocacy groups. It will prove invaluable for healthcare organizations seeking to improve quality of care, clinical training programs, and courses on quality assessment, healthcare management, and mental health policy.

Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.

One in five U.S. adults experiences a mental illness within a given year. With more than 550,000 people working to support this underserved community, the mental healthcare system has grappled with inadequacies and shortcomings in safety, quality, and care delivery. There is a wide range of problems, from access-to-care issues and errors, to complications stemming from poor care. Our country is also on an unsustainable path as our healthcare expenditure keeps growing. To add to all of this, we are facing a rampant epidemic of burnout among healthcare workers. Modern advancements introduced with many promises—such as electronic medical records, newer medications, or advanced treatments—have created unique challenges when ushered into a highly regulated healthcare system. What does it take to provide patients with everything they need—the right quality of care, at the right time, and at the right cost—to keep them healthy? Which process steps add value? Which steps are wasteful? A widely accepted fact is that a conservative 30-50% of every step in the mental healthcare process does not help patients feel better or stay better. When considering delays in care, workarounds, excessive documentation, and an overuse of auditing, the care system has moved highly skilled clinicians away from providing value, as administrative tasks continue to encroach on their time. There is a clear need to rethink and redesign the system of care. This book is a primer for understanding the current state of the mental health system and the performance improvement skills and leadership acumen needed to address existing challenges. Sheppard Pratt, the award-winning, leading institution for mental healthcare in America, provided the focus on mental healthcare and became the laboratory for this body of work over the course of eight years. It hired a seasoned systems thinker with improvement expertise to work with mental health professionals and solve some of their most complex and chronic problems. The book is a result of the collaboration between a practicing psychiatrist in a leadership role and the systems engineer. Working together, they demonstrate how to think about redesigning care and redefining the nature of work to enhance value for both the people served and the healthcare workforce. They crafted a multi-pronged approach towards culture change at Sheppard Pratt, including implementing a course on "Learning to Improve," which introduced staff to a performance improvement methodology. There are several vignettes interwoven throughout the book that describe the complexities and constraints of the system. Solving some of these challenges creates a new paradigm of work while minimizing waste and enhancing value.

A leading psychiatrist and expert reveals important issues in mental health care today and introduces innovations to revolutionize and improve mental health for everyone. Mental health care systems are falling short and the consequences, for individuals and societies, are dire. In this urgent book, celebrated psychiatrist and mental health care advocate Dr. David Goldbloom outlines proven innovations in medicine and health care delivery that we all could benefit from today. Using fictional—but all too real—examples of people suffering from various mental illnesses, from depression to opioid addiction, and drawn from his real-life experiences in this field, Dr. Goldbloom shows barriers to care and other faults in mental health care systems. He then reveals simple, yet startlingly effective tools for improving access and treatment that can help people now—if we only had the will to share, use, and fund these (and more) brilliant innovations: -Self-referrals for faster access to care -Apps and e-tools for treatment, rehabilitation, and self-monitoring between appointments -Remote coaching for effectively treating common childhood problems -Integrated youth services to improve early intervention -Personalized care to ensure treatments don’t fail patients -Rapid-access housing for the homeless and mentally ill so they can begin a journey of care While technologies such as smart phones and genetic testing play a role, these innovations are about people. They address waiting times to see specialists, the lack of coordination between health care institutions, and the stigma that often comes with seeking help—even stigma among health care providers. They broaden the definition of what mental health care can even be, such as providing housing, or low-intensity training for day-to-day life. Smart, candid, personal, and persuasive, this new book is a timely call for better access to and quality of help—a roadmap to better well-being for everyone.

Technology and Mental Health provides mental health clinicians with expert, practical, clinical advice on the questions and considerations associated with the adoption of mental health technology tools in the computer age. Increasingly, clinicians want to use technology to provide clients support through smartphones and mobile applications or to reach clients in remote or rural areas. However, using these tools in practice raises many practical and ethical questions. The book explains current technological developments in therapy, including mobile apps, telemental health, and virtual reality programs. Each chapter gives real-world guidance on adopting and using technology interventions, and the book spans a wide range of populations. Providers are introduced to the evidence supporting various technology-based interventions and areas for future development. Combining theory, research, and case studies, this practical guide teaches clinicians how to integrate technology into therapeutic interventions with clients.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.