Issues Associated with the Implementation of Routine Outcome Measures in Public Mental Health Services

Abstract

Objective: The purpose of this paper is to examine strategies that may facilitate the successful implementation of service-wide outcome measures in public mental health services. Conclusions:The available evidence suggests that a top-down approach to the introduction of state-wide routine outcome measurement across all public mental health services is likely to have only limited success. A centrally co-ordinated but locally directed bottom-up approach may be a more successful long-term strategy. Such an approach could make optimum use of a small team of "outcome experts", while the use of strategies such as the development of local clinical guidelines would increase the co-operation and participation of the wider clinical community. An initial collection of clinical and social demographics could provide important contextual information on service populations and would initiate the administrative and communication networks that would need to be developed for later routine, multi-site data collection.

Routine measurement of outcomes in Australia's public sector mental health services

“…Stakeholders in the current study repeatedly stressed that this commitment will only be sustained in the long term if clinicians and managers value routine outcome measurement. Feedback to these groups in the form of reports tailored to their specific needs is crucial, and has been identified by others as necessary for maintaining momentum [2-4,13,14]. …”

Professional Identity of Counselors in Mexico: A Commentary

“…It is commonly known that top-down approaches across public services generally have limited success. Conversely, long-term strategies that enhance the successful implementation of public mental health services are best when they are centrally facilitated from a locally directed, bottom-up approach (Rock, Combrinck, & Groves, 2001). From both a service delivery and administrative perspective, a bottom-up strategy has its advantages.…”

“…From both a service delivery and administrative perspective, a bottom-up strategy has its advantages. One obvious benefit is that it requires local stakeholders to articulate objective and verifiable goals that use a "common currency" (p. 44) or terminology (Rock et al, 2001).…”

“…Despite the array of treatments for mental health, little evidence exists regarding their feasibility and effectiveness when integrated into routine care settings among low-and middle-income countries. Even though bottom-up approaches offer advantages, they also require outcome measurements, something that mental health workers have found traditionally burdensome (Rock et al, 2001). For example, evidence-based mental health interventions for people exposed to conflict and other disasters are weak, especially for strategies implemented in the midst of emergencies (Patel, Araya, et al, 2007).…”

Optimizing clinical care through implementation of outcome monitoring systems

“…This provides a valid mechanism by which to compare the performance of agencies with one another and against an established set of norms. In this context, the purpose of routine outcome measurement is to provide reliable, aggregated and comparable data that can be used to examine and evaluate the quality of health care delivery (Rock, Combrinck, & Groves, 2001).…”