Role of psychologists in enhancing care quality for individuals with serious mental illnesses: Introduction to a special section.

This special section underscores the importance of psychologists in improving and enhancing care for individuals with serious mental illnesses (SMIs). People with diagnoses typically included in the category of SMIs-schizophrenia, schizoaffective disorder, bipolar disorder, and other diagnoses with symptoms severely impacting functioning-typically have layered marginalities and experience significant social stigma in addition to mental health symptoms. The complexity of challenges commonly experienced by individuals with SMI requires that treatment providers have specialized knowledge, training, and skills to provide specialty care needed to support mental health recovery.

Leveraging Measurement-Based Care to Reduce Mental Health Treatment Disparities for Populations of Color.

Disparities in mental health treatment have consistently been documented for clients of color as compared to White clients. Most mental health care disparities literature focuses on access to care at the point of initial engagement to treatment, resulting in a dearth of viable solutions being explored to retain clients in care once they begin. Measurement-based care (MBC) is a person-centered practice that has been shown to improve the therapeutic relationship, make treatment more personalized, and empower the client to have an active role in their care.

Can Measurement-Based Care Reduce Burnout in Mental Health Clinicians?

Burnout is a syndrome characterized by mental and emotional fatigue or exhaustion, depersonalization, and a lessened sense of personal accomplishment and efficacy. Burnout leads to negative consequences for mental health clinicians and for mental health care organizations. Measurement-based care (MBC) is a clinical process in which clinicians and clients use patient-generated data, also called treatment feedback, to collaboratively monitor mental health care and to inform goal-setting and treatment planning.

Outcomes for treatment of depression in the Veterans Health Administration: Rates of response and remission calculated from clinical and survey data.

Healthcare Effectiveness Data and Information Set (HEDIS) quality measures for depression treatment aggregate Patient Health Questionnaire (PHQ)-9 data from routine clinical assessments recorded in electronic health records (EHR). To determine whether aggregated PHQ-9 data in US Veterans Health Administration (VHA) EHRs should be used to characterize the organization's performance, we compared rates for depression response and remission calculated from EHRs with rates calculated with data representing the underlying Veteran patient population estimated using Veterans Outcome Assessment (VOA) survey data. We analyzed data from initial assessments and 3-month follow-up for Veterans beginning treatment for depression.

Measurement-based care in Veterans Health Administration mental health residential treatment.

In 2016, the Veterans Health Administration (VHA) launched the Measurement-Based Care (MBC) in Mental Health Initiative to support the use of patient-reported outcome measures (PROMs) across mental health services to increase veteran engagement and promote collaborative treatment planning. The present study reported on the administrations of PROMs across all residential stays within the VHA's Mental Health Residential Rehabilitation Treatment Programs between October 1, 2018, and September 30, 2019 ( = 29,111). We subsequently explored a subsample of veterans attending substance use residential treatment during the same period who completed the Brief Addiction Monitor-Revised (BAM-R; Cacciola et al.

Progress toward a performance measure for mental health based on a generic patient- reported outcome measure: Findings from the Veterans Outcome Assessment survey.

We report on studies conducted to develop outcome-based performance measures (PROM-PMs) based on generic patient-reported outcome measures (PROMs) that could support strategies for quality improvement applicable to all patients in a mental health system. Data were from the Veterans Outcome Assessment Survey at baseline and three months for the Mental Component Score (MCS-12), a widely used measure of mental health-related quality of life, for 15,540 outpatients beginning treatment in General Mental Health clinics in 140 Veterans Affairs (VA) facilities. Mental health diagnoses from medical records were coded using hierarchical categories.

Patient and Treatment Characteristics Associated With Receipt of Core Patient-Reported Outcome Measures in VA Mental Health.

Objective: Measurement-based care (MBC) has been implemented in Veterans Affairs since 2016 and is increasingly used in other mental health care organizations. Little quantitative research exists that assesses patient-level barriers and facilitators of MBC. This study examines correlates of receiving patient-reported outcome measures (PROMs) among veterans receiving both psychotherapy and pharmacotherapy (Both), psychotherapy only (Psychotherapy), and pharmacotherapy only (Pharmacotherapy).

Measurement-Based Care for Psychotic Disorders in the Veterans Health Administration: Current Practices and Future Directions.

Measurement-based care (MBC) improves patient outcomes. However, there has been minimal focus on MBC for psychotic disorders. This study examines the use of patient-reported outcome measures (PROMs) in the Veterans Health Administration (VHA) to characterize their use among Veterans with psychotic disorders and to inform candidate measures for psychosis-related MBC.

The effect of military sexual trauma on competitive employment status following veterans health administration supported employment services.

Military sexual trauma (MST) is prevalent, and some initial evidence suggests it is associated with impaired employment outcomes. The Veterans Health Administration (VHA) offers supported employment (SE) and Community-Based Employment Services (CBES), which consist of individualized employment support integrated with mental health treatment. The objective of this study was to examine the prevalence and effect of MST on competitive employment outcomes following participation in SE or CBES.

Collect, Share, Act: A transtheoretical clinical model for doing measurement-based care in mental health treatment.

[Correction Notice: An Erratum for this article was reported online in on Feb 27 2023 (see record 2023-49917-001). In the original article, changes were needed to correct the unintentional omission of noteworthy work in the area discussed and to improve clarity. In the fifth paragraph of the introductory section, the first two sentences have been edited.

A modified measurement-based care approach to improve mental health treatment engagement among racial and ethnic minoritized youth.

Despite high levels of need, racial and ethnic minoritized (REM) youth are much less likely than their White peers to engage in mental health treatment. Concerns about treatment relevance and acceptability and poor therapeutic alliance have been shown to impact treatment engagement, particularly retention, among REM youth and families. Measurement-based care (MBC) is a client-centered practice of collecting and using client-reported progress data throughout treatment to inform shared decision-making.

Interpreting patient reports of perceived change during treatment for depression: Findings from the Veterans Outcome Assessment survey.

This study addressed ongoing questions about the meaning of patients' perceptions of change during treatment. The study used data from the Veterans Outcome Assessment survey for patients with a depressive disorder, without mental health comorbidities, treated in Department of Veterans Affairs general mental health clinics (n = 694). Perceived changes in problems/symptoms, other domains, and the quality of communication with providers were evaluated with items from the Experience of Care & Health Outcomes (ECHO) survey.

"Observations from the national implementation of Measurement Based Care in Mental Health in the Department of Veterans Affairs": Correction.

Reports an error in "Observations from the national implementation of Measurement Based Care in Mental Health in the Department of Veterans Affairs" by Sandra G. Resnick and Rani A. Hoff (, 2020[Aug], Vol 17[3], 238-246).

Performance of the PHQ-9 across conditions and comorbidities: Findings from the Veterans Outcome Assessment survey.

Background: The items of the Patient Health Questionnaire-9 (PHQ-9) represent the criterion symptoms for DSM-IV major depression. This study evaluated the extent to which the PHQ-9 functions as a patient-reported outcome measure (PROM) specific to patients with major depressive disorder.

Method: Data were from the Veterans Outcome Assessment survey for 8848 patients beginning treatment in VA general mental health clinics, including 5754, re-surveyed after 3 months.

Associations between patient experience and clinical outcomes in substance use disorder clinics: Findings from the veterans outcomes assessment survey.

Background: Patient-centeredness is a cornerstone of substance use disorder (SUD) treatment. Patient-experience measures are potential tools for the routine assessment of patient-centered SUD care and may be valuable measures to inform quality monitoring improvement efforts. Little research exists on the predictive validity of patient-experience measures in SUD care.

Motivational interviewing: Key ingredients associated with taking a step toward employment.

This study sought to identify key ingredients of motivational interviewing (MI) associated with taking a step in the direction of competitive employment (CE) for unemployed veterans with serious mental illness (SMI). Data were analyzed from 195 audiotaped MI sessions targeted to employment conducted with 39 veterans with SMI. Sessions were coded and analyzed to identify components of MI practice predictive of taking any step in the direction of CE (e.

Employment After Vocational Rehabilitation Predicts Decreased Health Care Utilization in Veterans With Mental Health Diagnoses.

Introduction: Although the benefits of employment for veterans with mental health conditions are well-known, the effect of veterans' employment on a health system has not been evaluated. The purpose of this study was to evaluate the effect of veterans' employment (versus unemployment) on subsequent health care utilization in the Veterans Health Administration (VHA).

Materials And Methods: This study used a sample of 29,022 veterans with mental health and substance use disorders who were discharged from VHA's employment services programs between fiscal years 2006 and 2010.

Associations between patient experience and clinical outcomes in general mental health clinics: Findings from the veterans outcomes assessment survey.

For mental health, evidence linking the patients' experiences of care with treatment outcomes is limited. We report findings from the Veterans Outcome Assessment (VOA) survey of Veterans beginning treatment in Veterans Health Administration (VHA) mental health programs with follow-up after approximately 3 months. In addition to assessments of symptoms and functioning, it includes key components of the Experience of Care and Health Outcomes (ECHO) survey including patient reports of communication with clinicians and of the overall quality of mental health care.

Measurement-based care and psychological assessment: Using measurement to enhance psychological treatment.

This special issue highlights new research in psychological assessment and measurement-based care. Psychological assessment has historically been central to the field of psychology. Measurement-based care, considered an evidence-based practice, is a special type of applied psychological assessment in which patient-reported outcome measures are used to track progress in care as part of a clinical process.

LeRoy Spaniol, PhD, 1938-2020.

Presents the obituary of LeRoy Spaniol, PhD (1938-2020). LeRoy was a professor at Boston University for 31 years and a cofounder and senior director at the Center for Psychiatric Rehabilitation from 1974 until his retirement. Leroy's dedication to service began early in his life as a seminarian, followed by his work as a therapist helping people heal from divorce and serious mental illness.

Using patient-reported outcome measures for program evaluation: Design and findings on intention-to-treat outcomes from the Veterans Outcome Assessment survey.

The Veterans Outcomes Assessment (VOA) program surveys Veteran Health Administration (VHA) patients when they begin mental health treatment and at follow-up at three months to obtain patient-reported outcomes measures (PROM). It complements VA's evolving program in measurement-based care by providing additional data that can be useful for program evaluation including assessments of patients who have not been seen for ongoing mental health care. In principle, it provides data on intention-to-treat outcomes for program evaluation to complement the outcomes for patients who are receiving ongoing treatment that can be derived from measurement-based care.

Psychiatric Rehabilitation Journal in the era of COVID-19.

The global health crisis caused by the coronavirus pandemic (COVID-19) has brought about previously unimaginable changes to all of health care, including the field of psychiatric rehabilitation. Given these dramatic changes, we pose this editorial to contemplate our mission and how we can best serve the field. We raise questions about how psychiatric rehabilitation will evolve and restate our steadfast commitment to publishing impactful research that shapes the field.