How do we measure mental health?

Mental health treatment can be complicated, and adjustments are often needed to make it as effective as possible. When treatment isn’t meeting the Veteran’s goals or leading to improvement, VA encourages the Veteran and provider to discuss potential reasons and consider modifications or alternative treatments that better meet the patient’s needs.

To help, VA uses standardized questionnaires to measure change along the way. This process, known as measurement-based care (MBC), transforms the way VA delivers mental health care. MBC involves the following steps:

• The Veteran routinely completes brief questionnaires about their symptoms and progress toward treatment goals.
• The provider and the Veteran review and talk about the results together, using the questionnaire as a starting point for discussing what’s working in treatment — and what’s not. The provider explains what the findings mean and may offer ideas for changing treatment based on the results.
• Based on these conversations and considering the Veteran’s perspective, the provider and Veteran work together to select the best treatment options.

Benefits of MBC

Data from MBC questionnaires can signal when treatment isn’t working. It also helps the clinician and Veteran develop a plan to get back on track. MBC helps foster an open dialogue between Veterans and their providers, ensuring that the treatment process is progressing toward each Veteran’s mental health goals. This dialogue may include meaningful conversations about personal goals, collaborative development of treatment plans, assessment of progress over time, and joint decisions about adjustments to the treatment plan. Veterans’ participation in developing their treatment approach has the added benefit of helping them to actively engage in their care.

Change can be challenging

Using MBC can be a pretty big adjustment for many mental health providers. Changing a health care practice is challenging even when the new method is simple, and the MBC approach involves several steps and many considerations. That’s why VA is rolling out MBC in phases, so that along the way we can learn from providers’ experiences the best ways to put MBC into practice.

Members of the VA Center for Integrated Healthcare, the VISN 4 MIRECC and the Behavioral Health QUERI are studying how providers at 10 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. Their results will be used to help providers at other VA sites figure out how to adopt MBC.

Coming to a VA location near you

Veterans in VA care may have already had MBC interactions with their providers. For those who have not, MBC is coming to a VA facility near you! VA is continuing to expand measurement-based care across its many medical centers, clinics and other facilities.

To learn more about MBC, download this handout.

For more information about the mental health treatment options offered at your local VA facility, visit the Mental Health Community Points of Contact Locator.

Interested VA providers can check out MBC resources, including handouts and trainings, on our MBC SharePoint page.

Laura O. Wray, Ph.D., is the executive director of the VA Center for Integrated Healthcare and an adjunct associate professor at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. 

David W. Oslin, M.D., is an associate professor of psychiatry at the Philadelphia VA Medical Center and the University of Pennsylvania Medical Center. Dr. Oslin serves as the director of the VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC) and the associate chief of staff for behavioral health at the Philadelphia VAMC. 

Mona J. Ritchie, Ph.D., L.C.S.W., is an implementation coordinator and research health scientist for the VA Behavioral Health Quality Enhancement Research Initiative and an instructor in the Department of Psychiatry at the University of Arkansas for Medical Sciences College of Medicine.