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Measurement-Based Mental Health Care

January 27, 2022

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VA is a leader in developing and implementing measurement-based care practices in mental health care. A VA physician, Dr. David Oslin, developed specialized software to record and track patient outcomes in a standardized manner. Today, some 75% of VA facilities use Oslin’s Behavioral Health Laboratory software to track Veterans’ mental health care.

Measurement-based care (MBC) is the use of patient-reported information to inform clinical care and shared decision-making among clinicians and patients and to individualize ongoing treatment plans. The information is collected as part of routine care. MBC can use many kinds of data, including lab results and vital signs. VA’s Measurement Based Care in Mental Health Initiative, which began in 2015, focuses on outcomes reported by Veterans themselves in response to regular questionnaires related to their mental health. The initiative uses the symptoms Veterans report to tailor mental health treatments to their individual needs.

The three pillars of the initiative are:

Collect: Veterans complete reliable, validated, and clinically appropriate measures at regular intervals.

Use: Together, clinicians and Veterans use that information to make decisions about care.

Share: Clinical information is shared with the Veteran and other clinicians involved in the Veterans’ care to facilitate results-driven, personalized treatment.

The data from MBC questionnaires, recorded in Dr. Oslin’s software, can signal to clinicians and patients when a current treatment plan isn’t working and help them develop a plan to get back on track. This information also helps foster an open dialogue between Veterans and their care providers, ensuring that the treatment process is progressing toward individual Veterans’ mental health goals. This dialogue can include meaningful conversations about personal goals, collaborative development of treatment plans, assessments of progress over time, and joint decisions about adjustments in the treatment plan.

In a study published in 2019, Dr. Oslin and his colleagues surveyed 230 mental health providers at 47 VA medical centers. They found that in the group they surveyed, measurement-based care was commonly used, and this type of care was useful to their patients. Currently, VA researchers are studying how providers at several VA sites are implementing MBC into their primary care and mental health integration programs. Their goal is to understand what it takes to help providers shift their practice to the MBC approach, with the goal of implementing the approach throughout VA.

Today, thanks to the work of VA researchers and others, standard-setting organizations including The Joint Commission (TJC) and the Utilization Review Accreditation Commission have begun to incorporate the use of MBC into their accreditation standards. TJC, for example, now requires that specialty mental health and substance use treatment facilities seeking the organization’s accreditation must use MBC in treating all common mental health and substance use conditions.

For his work in implementing MBC within VA and for other achievements, Dr. Oslin received the John B. Barnwell Award for 2020. The award is VA’s highest honor for outstanding achievements in clinical science research and is given for scientific contributions that change clinical practice for Veterans.

Principal investigator: Dr. David Oslin, Corporal Michael J. Crescenz VA Medical Center

Selected publications:

Provider attitudes and experience with measurement-based mental health care in the VA implementation project. Oslin DW, Hoff R, Mignogna J, Resnick SG. Psychatr Serv. 2019 Feb 1;70(2):135-138.

Enhancing implementation of measurement-based mental health care in primary care: a mixed-methods randomized effectiveness evaluation of implementation facilitation. Wray L, Ritchie MJ, Oslin DW, Beehler GP. BMC Health Services Research 18, 753(2018).

Measurement based care in mental health initiative, U.S. Department of Veterans Affairs handout, May 2016.

Measurement-based care in the treatment of mental health and substance use disorders, Meadows Mental Health Policy Institute, March 2021.

Dr. David Oslin named recipient of the 2020 VA Barnwell Award, VA Office of Research and Development website, Feb. 11, 2021.

VA enhances mental health treatment with measurement based care, VA Vantage Point blog, June 17, 2020.



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