A routine outcome measure for youth mental health: Clinically interpreting MyLifeTracker

Abstract

Aim: MyLifeTracker is a session-by-session mental health outcome measure for young people aged 12 to 25 years. The aim of this study was to determine clinically significant change indexes for this measure that would identify developmentally appropriate thresholds. The study also aimed to determine expected change trajectories to enable clinicians to compare a client's progress against average rates of change. Methods: Participants comprised young people aged 12 to 25 years from both a clinical and a community sample from Australia. The clinical sample was 63 840 young people that attended a headspace centre. The non-clinical group was an Australian representative community sample of 4034 young people.Results: Clinically significant change indexes were developed for MyLifeTracker specific for age and gender groups by comparing clinical and non-clinical samples. Males and young people aged 12 to 14 years needed to reach higher scores to achieve clinically significant change compared to females and other age groups, respectively. MyLifeTracker expected change trajectories followed a cubic pattern for those with lower baseline scores of 0 to 50, whereas those with baseline scores of 51 and above had varying patterns. For those with lower baseline scores, expected change trajectories showed that stronger change was evident early in treatment, which then tapered off before accelerating again later in treatment. Conclusions:The development of MyLifeTracker benchmarks allows the measure to be used for Feedback Informed Treatment by supporting treatment planning and decision-making. This information can help clinicians to identify clients who are not on track or deteriorating and identify when clients are improving. K E Y W O R D S clinically significant change, expected change, MyLifeTracker, routine outcome measure, youth mental health 1 | INTRODUCTION MyLifeTracker (MLT) is a recently developed mental health outcome measure for routine monitoring specifically targeted for young people aged 12 to 25 years. It was co-designed with both young people and youth mental health clinicians to assess meaningful outcomes in the domains of general wellbeing, daily functioning, relationships with friends, relationships with family and coping. MLT has shown evidence

Factors affecting the implementation of an outcome measurement feedback system in youth mental health settings

“…The implementation of MLT as a part of the electronic data collection system used across headspace services is highly progressive. However, it was initially implemented for monitoring and evaluation purposes, rather than for clinical utility, which has only been more recently supported (Kwan et al, 2018;Kwan & Rickwood, 2020;Rickwood et al, 2018;Rickwood et al, 2015). Therefore, these results are unsurprising but reinforce the need for the organisation to focus on these neutral or negative perceptions of championing, training, and clinical support to support MLT use.…”

“…Importantly, benchmarks have recently been created for MLT in the form of clinically significant change indexes by age group and gender and expected change trajectories established by baseline MLT scores (Kwan & Rickwood, 2020). These benchmarks are yet to be incorporated within the headspace electronic data collection system, where they will provide additional clinical information for clinicians and clients.…”

“…It is therefore recommended Psychotherapy Research 9 that formalised training, clinical supports, and treatment guidelines are created. This should include the evidence for the use of brief measures in MFS (Østergård et al, 2020), a guide on how clinical benchmarks can help inform treatment planning (Kwan & Rickwood, 2020), and a structured framework of how to discuss feedback with clients (Law & Wolpert, 2014). MLT consists of five items targeting areas of importance to young people, and these items can be individually tracked (Kwan et al, 2018;Moses & Claypool, 2018).…”

‘More than just numbers on a page?’ A qualitative exploration of the use of data collection and feedback in youth mental health services

“…To avoid the risk of it becoming a purely bureaucratic exercise, outcome measurement should be meaningful to clinicians, young people, and families and carers [ 6 , 45 , 49 – 52 ]. The dearth of clinically meaningful outcome measures designed for young people has been previously highlighted [ 53 ], but such measures are being developed [ 54 , 55 ]. It has also been advocated that using idiographic outcome measures (e.g.…”

The Neuropsychological Symptoms Self‐Report: psychometric properties in an adolescent and young adult mental health cohort

“…This suggests that either female and younger participants had differential reporting behaviours, or improvements in subjective cognitive function are harder to achieve in these groups. Partial support for the latter hypothesis comes from a large Australian cohort study of young people, which monitored subjective quality of life using MyLifeTracker and found that younger male adolescents aged 12 to 14 years needed to reach higher scores to achieve clinically significant change compared to those aged 15–25 years (Kwan & Rickwood, 2020). Hence, while attention to cognition concerns should be paid to all young people receiving mental health treatment, our data suggest females and younger adolescents may be especially affected.…”