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Cited by 457Healthcare Quality and ManagementPsychiatric care and mental health servicesPrimary Care and Health Outcomes

Measuring and improving the quality of mental health care: a global perspective

Open access
Kilbourne, Amy M., Beck, Kathryn, Spaeth‐Rublee, Brigitta, Ramanuj, Parashar, O'Brien, Robert W., Tomoyasu, Naomi, Pincus, Harold Alan·2018·World Psychiatry
DOI 10.1002/wps.20482PMC PMC5775149
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Abstract

Mental disorders are common worldwide, yet the quality of care for these disorders has not increased to the same extent as that for physical conditions. In this paper, we present a framework for promoting quality measurement as a tool for improving quality of mental health care. We identify key barriers to this effort, including lack of standardized information technology‐based data sources, limited scientific evidence for mental health quality measures, lack of provider training and support, and cultural barriers to integrating mental health care within general health environments. We describe several innovations that are underway worldwide which can mitigate these barriers. Based on these experiences, we offer several recommendations for improving quality of mental health care. Health care payers and providers will need a portfolio of validated measures of patient‐centered outcomes across a spectrum of conditions. Common data elements will have to be developed and embedded within existing electronic health records and other information technology tools. Mental health outcomes will need to be assessed more routinely, and measurement‐based care should become part of the overall culture of the mental health care system. Health care systems will need a valid way to stratify quality measures, in order to address potential gaps among subpopulations and identify groups in most need of quality improvement. Much more attention should be devoted to workforce training in and capacity for quality improvement. The field of mental health quality improvement is a team sport, requiring coordination across different providers, involvement of consumer advocates, and leveraging of resources and incentives from health care payers and systems.

AI snapshot

Written from the paper’s full text.

TL;DR

This global perspective paper argues that mental health care quality remains suboptimal and that systematic quality measurement is needed to improve it. It reviews barriers, international innovations, and recommendations for embedding measurement-based care and common data elements into mental health systems.

Key findings

  • Mental disorders account for 32% of years of disability and 13% of disability-adjusted life years worldwide; persons with severe mental illness die 8–25 years younger than the general population.
  • Quality gaps persist: in the US, only one third of those in need receive adequate mental health care, and less than half of patients with publicly funded insurance get adequate follow-up after mental health hospitalization.
  • Of over 500 measures for monitoring mental health care quality, only 5% are used in major US quality reporting programs, only 10% have been endorsed by the US National Quality Forum, and 72% focus on processes quite distal to outcomes.
  • International innovations include measurement-based care programs such as the UK IAPT initiative, expanded for at least 1.5 million adults to access care each year by 2020/21, and the Dutch Depression Initiative, included in the Netherlands’ national essential benefits.

Methods

  • Design: narrative global perspective/review and framework paper; no primary empirical study or systematic review methods are described.
  • Data/sample: draws on published literature and international examples from the US, UK, Netherlands, Australia, New Zealand, Canada, and WHO to illustrate quality measurement and improvement.
  • Analysis: conceptual synthesis using the Donabedian structure–process–outcome framework and a learning health care system framework; recommendations are derived from identified barriers and innovations.

Limitations

  • The paper does not report a formal limitations section; it states field-level barriers including lack of standardized information technology-based data sources, limited scientific evidence for mental health quality measures, lack of provider training and support, and cultural barriers to integrating mental health care.
  • Evident from the text: as a narrative perspective, it lacks systematic search/selection criteria and primary data, and its recommendations rely on selected international examples and expert opinion.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/wps.20482

Cites

88 of 88 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 60 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    In the United States, only about one third of people needing mental health care receive adequate care.

    “In the US, only a third of those in need receive adequate mental health care 25 .”
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  • Premisecitation

    Not all existing mental health process measures that could be reported have been validated.

    “Still, even among existing mental health process measures that could be reported, not all have been validated 25,26,[33][34][35][36][37][38][39] .”
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    Fewer than half of patients with publicly funded insurance receive adequate follow-up after mental health hospitalization.

    “For example, recent data indicate that less than half of patients with publically funded insurance get adequate followup after mental health hospitalization 27 .”
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  • Premisecitation

    The IAPT program was expanded in the UK so that at least 1.5 million adults could access care each year by 2020/21.

    “Notably, after initial pilot testing and successful evaluation, the IAPT was expanded in the UK for at least 1.5 million adults to access care each year by 2020/21 47 ,”
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    The Dutch Depression Initiative primary mental health collaborative care model was included in the Netherlands' national essential benefits under the Health Insurance Act.

    “and the Depression Initiative primary mental health collaborative care model was included in the Netherlands into the list of national essential benefits as part of the Health Insurance Act 45 .”
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    Premisereasoning

    Adequate structure measures create infrastructure for reporting processes and outcomes and for improvement activities, but they do not show whether services are delivered with fidelity or whether outcomes are acceptable.

    “However, while adequate structure measures create the necessary infrastructure for report-ing on processes and outcomes and conducting improvement activities, they do not provide sufficient detail as to whether quality services are actually being delivered as intended (fidelity) nor if the outcomes obtained are acceptable.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    Mental disorders are common globally, but the quality of care for them has not risen as much as for physical health conditions.

    “Mental disorders are common worldwide, yet the quality of care for these disorders has not increased to the same extent as that for physical conditions.”
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    Premisenone given

    Structure, process, and outcome measures have all been used for accreditation, standard setting, quality improvement, and accountability in health care generally and in mental health care.

    “In general, structure, process and outcome measures have all been employed for accreditation, standard setting, quality improvement and accountability in health care generally and in mental health care.”
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    Premisecitation

    Mental health care quality is poor and improves more slowly than general medical care quality.

    “The level of mental health quality of care is poor and the rate of improvement is slow compared to general medical conditions 26 .”
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    Premisecitation

    Despite the global burden of mental disorders, mental health care quality remains suboptimal and gaps in access to and receipt of services persist worldwide.

    “Despite the contribution of mental disorders to the global burden of disease, the quality of care for these disorders remains suboptimal, and there are persistent gaps in access to and receipt of mental health services worldwide [12][13][14][15][16][17][18] .”
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    Premisecitation

    These measurement-based care programs do not reach all patients with mental disorders, and most health care providers do not routinely apply measurement-based care.

    “However, these programs do not reach all patients with mental disorders, and a majority of health care providers do not routinely apply measurement-based care 48,49 .”
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    Premisecitation

    Among people with mental disorders, disparities in care quality and outcomes are larger for racial and ethnic minorities and for lower socioeconomic status groups.

    “Among persons with mental disorders, disparities in quality and outcomes of care are more pronounced for racial/ethnic minorities [6][7][8] , and those from lower socio-economic status groups 9 .”
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    Premisecitation

    Some recently reported measures for improved processes of care, such as appropriate pharmacotherapy, continuity of care, and psychotherapy use, are associated with reduced mortality and reduced symptom severity.

    “Some notable exceptions that have been reported recently show that measures for improved processes of care (e.g., appropriate pharmacotherapy, continuity of care, and psychotherapy use) are associated with reduced mortality [28][29][30][31] and reduced symptom severity 32 .”
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    Premisecitation

    Severe mental illness is becoming a major health disparity category, with estimates that affected persons die 8 to 25 years earlier than the general population.

    “Severe mental illness (e.g., schizophrenia and bipolar disorder) is emerging as a prominent health disparity category, given estimates that persons in this group die 8-25 years younger than the general population 10,11 .”
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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    Efforts to standardize mental health care quality measurement are evolving slowly worldwide.

    “Worldwide, efforts to standardize mental health care quality measurement are slowly evolving.”
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    Premisenone given

    Measuring mental health care quality is difficult worldwide and can vary with how services are organized in each country.

    “However, measuring quality of mental health care is challenging worldwide, as it can vary based on the organization of services by country.”
    Quote in the paperSubstantial claim

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    Premisecitation

    The chronic care model has been shown in multiple randomized trials to improve physical and mental health outcomes across different mental disorders with little to no added cost.

    “The chronic care model has been shown in multiple randomized trials to improve physical and mental health outcomes across different mental disorders, with little to no added cost 42 .”
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    Premisenone given

    Structural components such as personnel, training, facilities, and policies supporting measurement-based care are fundamental to high-quality care.

    “Health care structural components, such as resources (personnel, training, facilities) and policies that support measurement-based care, are fundamental to achieving high quality care.”
    Quote in the paperNot a substantial claim

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    Premisenone given

    Only a few studies have linked quality-of-care process measures to improvements in patient functioning and clinical outcomes, which calls the clinical validity of these measures into question.

    “Only a few studies have linked quality of care process measures to improvements in patient functioning and clinical outcomes, calling into question the clinical validity of these measures.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    Routine measurement and reporting of care quality enables quality improvement at provider, clinic, and system levels and supports accountability mechanisms such as public reporting and financial rewards or penalties.

    “Measuring and reporting quality of care on a routine basis enables the application of quality improvement at provider, clinic and health system levels, as well as accountability mechanisms that include public reporting and financial penalties and rewards.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Systematic measurement of mental health care quality can improve the quality of that care.

  • May combine two claims.

    Premisecitation

    The overall quality of mental health care has barely improved since the Institute of Medicine reports and has worsened in some cases.

    “Nonetheless, the overall quality of mental health care has hardly improved since publication of these reports and, in some cases, has worsened over time 24 .”
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    Premisenone given

    Measures are lacking for common mental health conditions such as anxiety disorders and are lacking in depth for evidence-based treatments such as psychotherapy.

    “Measures are also lacking for mental health conditions commonly experienced in populations, such as anxiety disorders, and lacking in depth for evidence-based treatments such as psychotherapy.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The IAPT initiative embedded routine outcome measurement using validated tools such as PHQ-9 and CORE and could demonstrate good outcomes that led to further funding.

    “One of these areas is the abovementioned IAPT initiative, which embedded routine outcome measurementusing validated tools such as the PHQ-9 and the Clinical Outcomes in Routine Evaluation (CORE) -and could demonstrate good outcomes that have led to further funding into the initiative 71 .”
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    Premisenone given

    The UK National Health Service has a long tradition of using electronic medical records in primary care for routine quality measurement, notably through the Quality Outcomes Framework.

    “For example, the UK National Health Service has a long tradition of using electronic medical records in primary care for routine quality measurement, most notably through the Quality Outcomes Framework, the largest payment-by-results program in the world.”
    Quote in the paperNot a substantial claim

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    Premisereasoning

    These non-health-care services often require coordination across providers, settings, agencies, and sectors, but there is little incentive to improve quality when no measures assess accountability.

    “These services often require coordination across different providers, settings, agencies and even sectors, but there is little incentive to improve quality when there are no measures to assess accountability for these services.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    International innovations in quality measurement include the WHO Assessment Instrument for Mental Health Systems and the International Initiative for Mental Health Leadership.

    “International innovations in quality measurement include the World Health Organization (WHO)'s Assessment Instrument for Mental Health Systems 76 , and the International Initiative for Mental Health Leadership 77 , which provides data on reporting, ability to report, and ascertainment of data across countries.”
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    Premisereasoning

    Mental health providers often use separate electronic medical record systems from general medical providers or lack access to such systems, creating challenges for engaging the mental health field in quality measurement and improvement.

    “In addition, mental health providers often use separate electronic medical record systems from their general medical provider counterparts, or do not have access to these systems at all, creating big challenges to engage the mental health field as a whole in quality measurement and improvement of care for patients who often require coordinated services across different sectors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Many mental health care quality measures are not linked to existing data sources, which mostly rely on claims data rather than electronic health records or electronically reported patient outcomes.

    “Currently, many mental health care quality measures are not linked to existing data sources, which mostly rely on claims data rather than data derived from electronic health records or electronicallyreported patient outcomes 26,65 .”
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    Premisereasoning

    Mental health care requires more team effort among psychiatrists, social workers, psychologists, and case managers, and mental health visits are typically longer because of the nature of the illnesses.

    “Mental health care also requires more of a team effort between psychiatrists, social workers, psychologists and case managers, and mental health visits are typically longer, due to the nature of the illnesses.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Administrative burden and risk of gaming led to professional resistance, and the NHS mental health outcome-based reimbursement program has been indefinitely postponed in favor of smaller work areas.

    “However, the administrative burden involved and the risk of gaming (i.e., biased reporting to improve apparent performance) has led to resistance from the profession 68,69 .The program has now been indefinitely postponed in implementation in favor of smaller areas of work 70 .”
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    Premisecitation

    In the US, despite parity laws and more than 500 measures for monitoring mental health care quality, only 5% of these measures are used in major quality reporting programs and only 10% have been endorsed by the National Quality Forum.

    “Yet, despite the mental health parity laws passed ten years ago, which stipulate equal coverage for mental health conditions, and the availability of over 500 measures for monitoring quality of mental health care, only 5% of these measures are actually used in the above major quality reporting programs, and only 10% of the measures have been endorsed by the US National Quality Forum 60”
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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisereasoning

    Consumers of mental health services may feel burdened by data gathering because of long-standing stigmatization and functional challenges.

    “Still, due to long-standing stigmatization and functional challenges, consumers of mental health services may feel burdened by the data gathering.”
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  • Classified as probably not a substantial claim.

    Premisenone given

    Limited scientific evidence for mental health quality measures is a barrier to mental health quality measurement.

    “This is due to a multitude of barriers specifically related to mental health, that involve limitations in policy and technology as well as limited scientific evidence for mental health quality measures, lack of provider training and support, and cultural barriers to integrating mental health care within general health environments.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisenone given

    Many patient needs that providers address are non-health-care services such as employment, housing, education, criminal justice, and welfare, and the quality of these services is rarely measured.

    “Moreover, many of the challenges that providers address with their patients include service needs beyond health care (employment, housing, education, criminal justice and welfare), and quality of care for these services is rarely measured to ensure improved mental health outcomes and recovery.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisenone given

    Australia mandated standard outcome measures for all mental health service users in 2000, and all Australian states signed agreements to submit routinely collected outcomes and case mix data.

    “In Australia, the use of standard outcome measures for all mental health service users was mandated in 2000, and all Australian states have signed agreements to submit routinely collected outcomes and case mix data.”
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    Premisenone given

    The Benchmarking Network was developed because of perceived inadequacy of the national data collection system and lack of feedback on the large amount of data collected.

    “The Benchmarking Network was developed because of the perceived inadequacy of the national data collection system and the lack of feedback on the large amount of data collected.”
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    Premisecitation

    The National Quality Forum uses a consensus process for review and endorsement of measures, including periods for public comment.

    “The National Quality Forum uses a consensus process for review and endorsement of measures, including periods for public comment 100 .”
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    Premisenone given

    In the Department of Veterans Affairs, quality measures are set by central leadership for implementation in more than 160 medical centers.

    “In the Department of Veterans Affairs, quality measures are set by central leadership for implementation in over 160 medical centers.”
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    Premisecitation

    The Measure Development Plan outlines a planned process that includes engaging stakeholders.

    “The Measure Development Plan outlines the planned process, including engaging stakeholders 99 .”
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    Premisecitation

    These initiatives reward providers for outcomes improvement and are increasingly used in mental health care.

    “These initiatives reward providers for outcomes improvement and are also increasingly becoming used in mental health care 90,91 .”
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    Premisenone given

    The main focus has been to integrate mental health treatment into primary care, where most patients with mental health symptoms initially present.

    “The main focus has been to integrate mental health treatment into primary care, where most patients with mental health symptoms initially present.”
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    Premisecitation

    Other innovations involve care beyond the clinic, including measurement of recovery-oriented services and incorporation of mobile health to capture outcome data.

    “Other innovations involve care beyond the clinic walls, including the measurement of recovery-oriented services 92 and incorporation of mobile health to capture outcome data 65,93 .”
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    Premisereasoning

    As a ground-up initiative, the Benchmarking Network required a large degree of engagement and dynamic leadership.

    “As a groundup initiative, the Benchmarking Network required a large degree of engagement and dynamic leadership.”
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  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The recommendations in this paper for improving mental health service quality are applicable to health care more broadly.

    “The recommendations for improving quality of mental health services presented here can apply to health care in general.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Mental health has pioneered other health care innovations, such as community-based care, integrated care models, and patient-centered recovery measures.
    • Rests on an assumption: Mental health services offer lessons that can guide the rest of health care toward a learning health care system.

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    Premisenone given

    The Dutch initiative stipulates that indicators are collected centrally and published transparently to stimulate continuous quality improvement.

    “The initiative stipulates that the indicators are collected centrally and published transparently to stimulate continuous quality improvement.”
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    Premisecitation

    Byron et al. describe a process of engaging stakeholders at all levels of measure development and implementation for CHIPRA quality measures.

    “Byron et al 98 describe a process of engaging stakeholders at all levels of measure development and implementation for Children's Health Insurance Program Reauthorization Act (CHIPRA) quality measures.”
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    Premisecitation

    Regular outcome assessment is linked to better service delivery and fewer readmissions.

    “Regular outcome assessments have been linked to improvements in service delivery and lower readmission rates 103”
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    Premisecitation

    Quality of mental health care in the Department of Veterans Affairs has been widely documented, and regional variations in processes and outcomes of care are common.

    “While quality of mental health care in the Department has been widely documented, regional variations in processes and outcomes of care are common [82][83][84][85][86] .”
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    The US Centers for Medicare & Medicaid Services is deploying initiatives to improve provider use and engagement in evidence-based practices and delivery system changes to sustain them.

    “The US Centers for Medicare & Medicaid Services is also deploying initiatives that seek to improve provider use/engagement in evidencebased practices as well as delivery system changes to sustain them.”
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    Premisenone given

    The targets are set locally but with centrally agreed goals.

    “The targets are set locally, but with centrally agreed goals.”
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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    While frontline clinicians often provide input for quality measure development, feedback from consumers and caregivers is considered essential for buy-in.

    “While frontline clinicians are often able to provide input for quality measures development, garnering feedback from consumers and their caregivers is also considered essential for buy-in 97 .”
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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Inevitable variations in care delivery make development of quality measures more difficult in mental health.

    “Nonetheless, inevitable variations in care delivery make the development of quality measures a more difficult process in the mental health field.”
    Quote in the paperNot a substantial claim

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    Premisecitation

    Implementing the Australian initiative on a large scale required considerable investment in mental health providers, ongoing training, and a broad engagement program.

    “To be able to implement this initiative on such a large scale required considerable investment in mental health providers, ongoing training and a broad program of engagement 79 .”
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    Premisecitation

    The UK National Health Service Benchmarking Network is a collaboration among all mental health provider organizations that supply data to benchmark their practice against others.

    “In the UK, the National Health Service Benchmarking Network 81 is a collabora-tion between all mental health provider organizations, which supply data to benchmark their own practice against others.”
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    Premisenone given

    Innovations such as natural language processing or automated capture of information from electronic medical records are already being used to facilitate data capture for information not readily apparent from claims data.

    “Innovations such as natural language processing, or the automated capture of information from electronic medical records, are already being used to facilitate data capture for information (e.g., homelessness or suicide risk) not readily apparent from claims data.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    Improving mental health care quality requires coordination among providers, participation of consumer advocates, and use of resources and incentives from payers and systems.

    “Improving quality of mental health care is a team sport, requiring coordination across different providers, involvement of consumer advocates, and leveraging of resources and incentives from health care payers and systems.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The Department of Veterans Affairs has launched national initiatives to improve quality and reduce disparities in mental health care, notably through the Uniform Mental Health Services Handbook and deployment of mental health care managers in primary care.

    “Hence, while regional service directors are ultimately responsible for improving quality, the Department has launched national initiatives to improve quality of care and reduce disparities in mental health care, notably through the implementation of the Uniform Mental Health Services Handbook 87 and the deployment of mental health care managers in primary care settings to promote integrated care.”
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    Premisenone given

    In the US, national efforts are underway to identify cross-cutting mental health care quality measures and to determine who owns responsibility for improving quality.

    “In the US, national efforts are underway to identify cross-cutting mental health care quality measures and to determine who”
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    Premisecitation

    The Centers for Medicare & Medicaid Services recently convened technical expert panels to help develop, select, and maintain measures, including clinicians, statisticians, quality improvement experts, and methodologists.

    “Moreover, the Centers for Medicare & Medicaid Services recently convened technical expert panels to help develop, select and maintain measures including clinicians, statisticians, quality improvement experts and methodologists 101 .”
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54 of 54

  • The paper relies on this without support.

    Systematic measurement of mental health care quality can improve the quality of that care.

    “We cannot improve what we cannot measure.”

  • The paper relies on this without support.

    The barriers to mental health quality measurement can be mitigated by the innovations described in the paper.

    “We describe several innovations that are underway worldwide which can mitigate these barriers.”

  • The paper relies on this without support.

    Implementing the paper's recommendations would improve the quality of mental health care.

    “Based on these experiences, we offer several recommendations for improving quality of mental health care.”

  • The paper relies on this without support.

    Mental health has pioneered other health care innovations, such as community-based care, integrated care models, and patient-centered recovery measures.

    “Indeed, mental health has led the way in other health care innovations, including moving care into the community, use of innovative models of integrated care, as well as measures of patientcentered recovery.”

  • The paper relies on this without support.

    Mental health services offer lessons that can guide the rest of health care toward a learning health care system.

    “Moreover, there are lessons learned from mental health services that will inform the rest of health care to adopt a learning health care system.”

  • The paper relies on this without support.

    Mental health consumers and their families have long advocated for patient-centered care and attention to personal goals beyond medical services.

    “For years, mental health consumers and their family members have advocated for”

  • The paper relies on this without support.

    The varied composition of mental health providers requires the health care system to consider frontline staff perspectives, including nurses, social workers, and peer specialists, in quality improvement.

    “The diverse nature of mental health providers also challenges the health care system to take into consideration the perspectives of frontline staff including nurses, social workers, and increasingly peer specialists in owning quality improvement.”

  • The paper relies on this without support.

    Systematic quality outcome measurement is often motivated by policy or cost goals rather than individual treatment decisions, which can make staff see it as a low-value distraction.

    “Too often systematic quality outcome measurement is driven by a desire to inform policy or reduce expenditure rather than improve treatment decisions for individuals, which may have an adverse effect if staff (who are meant to be collecting the data) perceive it as a distraction with little value.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • UK Benchmarking Network citation points to a VA report

    Minor

    The cited reference 81 is titled as a report on the US Department of Veterans Affairs, not the UK National Health Service Benchmarking Network named in the text.

  • Veterans Affairs handbook citation points to a UK framework paper

    Minor

    The text cites reference 87 for the Department of Veterans Affairs Uniform Mental Health Services Handbook, but reference 87 is a paper about the quality and outcomes framework.

2 of 2

Cites

Flagged first, then by citations

2 of the 90 references couldn’t be matched to a known paper.

Research works printed but not linked: 18

  1. England NHS, 2016, Adult mental health: common mental health problems. Implementing the five year forward view for mental health
  2. US Department of Defense, 2016, Plan for development of procedure to measure data on mental health care provided by the Department of Defense
  3. US Institute for Clinical Systems Improvement, 2016, The DIAMOND program: treatment for patients with depression in primary care
  4. US Centers for Medicare & Medicaid Services, 2017, Value‐based payment modifier
  5. US Centers for Medicare & Medicaid Services, 2017, Physician compare
  6. US Centers for Medicare & Medicaid Services, 2017, Hospital compare
  7. US Centers for Medicare & Medicaid Services, 2017, Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program
  8. Institute of Medicine US, 2015, Psychosocial interventions for mental and substance use disorders: a framework for establishing evidence‐based standards
  9. Gaynes B, 2015, Relationship between use of quality measures and improved outcomes in serious mental illness
  10. US Substance Abuse and Mental Health Services Administration, 2015, Recovery and recovery support
  11. Royal College of Psychiatrists UK, 2014, Royal College of Psychiatrists' statement on mental health Payment Systems (formerly Payment by Results)
  12. US Department of Veterans Affairs, 2017, VA is working to end homelessness among veterans
  13. World Health Organization, 2009, WHO‐AIMS mental health systems in selected low‐income and middle‐income countries: a WHO‐AIMS cross‐national analysis
  14. International Initiative for Mental Health Leadership, 2016, IIMHL and IIDL Annual report
  15. US Institute of Medicine, 2015, Quality measurement. Psychosocial interventions for mental and substance use disorders: a framework for establishing evidence‐based standards
  16. US Centers for Medicare & Medicaid Services, 2016, CMS quality measure development plan: supporting the transition to the Merit‐based Incentive Payment System (MIPS) and Alternative Payment Models (APMs)
  17. US Centers for Medicare & Medicaid Services, 2017, Technical expert panels
  18. NHS Scotland, 2008, Mental health project final report

Cited by

Sorted by citations

Related

Authors
Kilbourne, A. M., Beck, K., Spaeth‐Rublee, B., Ramanuj, P., O'Brien, R. W., Tomoyasu, N., & Pincus, H. A.
Affiliations
  • United States Department of Veterans Affairs (US)
  • University of Michigan (US)
  • New York State Psychiatric Institute (US)
  • Royal National Orthopaedic Hospital (GB)
  • Health Services Research and Development Service, Veterans Health Administration, US Department of Veterans Affairs Washington DC USA
  • NewYork–Presbyterian Hospital (US)
ORCID
Venue
World Psychiatry
Publisher
Wiley
Published
2018-01-19
Volume
17
Issue
1
Pages
30-38
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
DOI
10.1002/wps.20482
PMC
PMC5775149
OpenAlex
W2791735926
Semantic Scholar
77dde787e7684202e28d70513dfd6e5cb57f97a7
Cited by
457
References
90
Citations by year
2026: 46 · 2025: 56 · 2024: 73 · 2023: 45 · 2022: 80 · 2021: 57 · 2020: 52 · 2019: 36 · 2018: 11
FWCI
49.21
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • World Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
  • Department of Veterans Affairs
  • National Institutes of Health (R01 MH 099898, UL1 TR000040)
  • Commonwealth Fund (20141104)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
mental health care quality, quality measurement, quality improvement, common data elements, electronic health records, measurement-based care, mental health workforce training, mental health integration, patient-centered outcomes, health care payers, consumer advocacy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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