Evidence-based mental health care: Measuring and monitoring for better patient outcomes

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But it’s critical that mental health treatment outcomes be measurable – to ensure that they drive positive improvements in patients’ quality of life, when they need it most.

It is encouraging that mental health conditions are losing the stigma they once had due to increased education and awareness. Additionally, people living with mental health conditions are becoming more willing to practise self-care, and to seek professional mental health treatment.

However, the stresses of modern living mean the need for care is soaring.

“Mental health is becoming a burning platform,” says Nina Strydom, senior support specialist at Life Healthcare. “We know that the prevalence of mental-health challenges are growing. Specifically, we are also seeing a significant increase in the need for adolescent mental-health care.”

Outcome measures

As the demand for mental health treatment increases, there is a parallel need for treatment, care and rehabilitation that is proven to be effective. To assess effectiveness, it must be measurable.

Fortunately, there is now a range of sophisticated, internationally recognised outcome measures that demonstrate the impact that mental healthcare services and treatment have on people being treated for mental-health conditions, specifically related to individuals who are admitted to mental healthcare treatment facilities.

These metrics allow outcomes to be accurately assessed - benefiting patients, funders and healthcare providers alike. By their nature, mental health and wellness are not easily assessed.

Therefore, it is even more crucial to have a credible methodology to measure mental health and track changes over time. Patients, their families, healthcare practitioners, and medical-aid providers need to know that individuals receiving mental healthcare are showing real improvement.

Mental health care practitioners such as psychiatrists, general practitioners, psychologists, occupational therapists and social workers use a variety of clinical outcome measures that have been developed to assist with diagnosing certain mental health conditions, as well as to assess the severity and/or improvement of the condition.

Among these assessment tools is the Mental Health Questionnaire-14 (MHQ-14), which is sensitive to changes during the average stay at a Life Mental Health facility. MHQ-14 is a an internationally recognised, standardised tool aimed at achieving material, measurable patient outcomes, and sets international standards for improvement over time.

“It is important for all industry stakeholders to know that patients’ mental health is improving during the course of their admission,” says Strydom. “But it also allows healthcare providers to benchmark against international standards.”

Patient reporting

MHQ14 is a patient-reported outcomes measure. A questionnaire is given to a patient to complete upon admission, and another is provided upon discharge. The measure is not impairment specific but measures the patient's perception of how they felt when they came in – a quality-of-life score – followed by another measure upon their discharge.

The measure covers 14 items in four domains – energy or vitality; how the person functions socially; how they function emotionally; and their perception of their general mental health.

Questionnaire data ultimately provides a holistic view of a patient’s mental health by covering multiple aspects of their wellbeing and helping healthcare providers to tailor treatments and interventions more effectively.

Marisa Roets, nurse manager at Life Poortview, explains, “Although outcome measurement tools in mental healthcare are subjective and based on the patient’s self-assessment of their journey, they offer an important opportunity for therapeutic dialogue between the mental healthcare provider and the patient. This dialogue can lead to improved patient experiences.”

She adds, “By measuring outcomes, the multidisciplinary team gains the advantage of being more agile and responsive in delivering individualised care.”

Better quality of life

Strydom says self-reporting ensures that patients themselves can be the judge of how they are doing.

“With patient-reported outcome measures, there is a level of subjectivity,” she says. “But it directly helps confirming that our patients leaving a unit feel better, that their inpatient stay was appropriate, and that it helped them.”

“It’s important that clinicians evaluate the facilities they refer their patients to for admission, ensuring the facility provides the appropriate level of care needed to support the patient in their mental health journey.

"This also means they have a responsibility to ensure health outcomes are measured and reported accurately,” says Strydom. “Patients themselves can also request that their GP or their mental healthcare professional consider particular facilities that are best suited for their admission, care and recovery.”

Disability of all kinds – including mental disability – can have serious impact on individuals, their families and places of employment which can lead to a significant economic burden for the country.

“Many people who do not receive adequate help to address the mental health conditions they live with are unable to work or support their families emotionally or financially,” says Strydom.

“Our goal is to help them reclaim their mental wellness, so that they can go back to work, back to their families and back to living fulfilling lives. Through utilising the MHQ-14, it contributes to achieving this goal where we gain valuable insights into patient mental health leading to better care and more effective treatment strategies.”