Measurement-Based Care in Psychiatric Practice: A Policy Framework for Implementation

This article describes the need for measurement-based care (MBC) in psychiatric practice and defines a policy framework for implementation. Although measurement in psychiatric treatment is not new, it is not standard clinical practice. Thus a gap exists between research and practice outcomes. The current standards of psychiatric clinical care are reviewed and illustrated by a case example, along with MBC improvements. Measurement-based care is defined for clinical practice along with limitations and recommendations. This article provides a policy top 10 list for implementing MBC into standard practice, including establishing clear expectations and guidelines, fostering practice-based implementation capacities, altering financial incentives, helping practicing doctors adapt to MBC, developing and expanding the MBC science base, and engaging consumers and their families. Measurement-based care as the standard of care could transform psychiatric practice, move psychiatry into the mainstream of medicine, and improve the quality of care for patients with psychiatric illness.

J Clin Psychiatry 2011;72(8):1136-1143

Submitted: May 26, 2010; accepted August 30, 2010.

Online ahead of print: January 11, 2011 (doi:10.4088/JCP.10r06282whi).

Corresponding author: Kelli Harding, MD, Columbia University, Department of Psychiatry, 1051 Riverside Dr, Unit 125, New York, NY 10032 ([email protected]).