Measuring Quality of Mental Health Care: A Review of Initiatives and Programs in Selected Countries

Abstract

French

This review article presents a systematic review of grey literature describing current initiatives that assess the quality of mental health care in 12 countries, as collected by the International Initiative for Mental Health Leadership. There have been increased efforts in many countries to develop and implement mental health indicator schemes to measure and monitor the quality of mental health care at the national and subnational level. Most mental health indicator sets are part of larger health policy initiatives at the national and (or) provincial or state level, with indicators and domains regularly reviewed and revised. The indicator sets described in health care quality initiatives vary widely in their scope, intended use, and degree of development, and they often cut across a broad range of domains, reflecting not only a country's specific health system and how it is organized and structured but also the implementation of such schemes (that is, collection and analysis of data) and the sociopolitical realities that determine mental health priorities.

Keywords

mental health quality indicators measures

References

Brown

Pirkis

Mental health quality and outcome measurement and improvement in Australia. Curr Opin Psychiatry. 2009;22:610–618.

National Mental Health Working Group Information Strategy Committee (ISC) Performance Indicator Drafting Group. Key performance indicators for Australian Public Mental Health Services. ISC discussion paper no 5. Canberra (AU): Australian Government Department of Health and Ageing; 2005.

The Australian Council on Healthcare Standards/Health Services Research Group at the University of Newcastle. Australasian clinical indicator report: 2001–2008. Determining the potential to improve quality of care. 10th ed [Internet]. Ultimo (AU): Australian Council on Healthcare Standards; 2008 [cited 2009 Dec 10]. Available from: http://www.achs.org.au/pdf/temp/Australasian_Clinical_Indicator_Report_200108_10thEdition.pdf.

Rosen

Hadzi-Pavlovic

Parker

The life skills profile: A measure assessing function and disability in schizophrenia. Schizophr Bull. 1989;15(2):325–337.

Rosen

Hadzi-Pavlovic

Parker

. The life skills profile. Background, items and scoring for LSP–39, LSP–20 and the LSP–16, May 2006 [Internet]. [place of publication and publisher unknown] 2006 May [cited 2009 Dec 10]. Available from: http://www.blackdoginstitute.org.au/docs/LifeSkillsProfile.pdf.

Pirkis

Burgess

Coombs

. Routine measurement of outcomes in Australia's public sector mental health services. Aust New Zealand Health Policy. 2005;2(1):8.

Alberta Mental Health Board Project Team. System level performance for mental health in Alberta 2007/08. Edmonton (AB): Alberta Mental Health Board; 2008 Jun.

Alberta Mental Health Board. Performance monitoring framework for Alberta's mental health system 2007. Edmonton (AB): Alberta Mental Health Board; 2008 Jan 17.

Lin

Durbin

Zaslavska

. Hospital report 2007: Mental health. Joint initiative of the Ontario Hospital Association and the Government of Ontario. [Internet]. Toronto (ON): Hospital Report Research Collaborative, University of Toronto; 2008 [cited 2009 Jul 6]. Available from: http://hospitalreport.ca/downloads/2007/mh_2007.html.

10.

Care Quality Commission. Performance Assessment 2008/2009. Mental health trust indicators. [Internet]. Newcastle-upon-Tyne (GB): Care Quality Commission; 2009 Apr 29 [cited 2009 May 11]. Available from: http://www.cqc.org.uk/_db/_documents/MH_EC_and_NP_200902261020.pdf.

11.

Healthcare Commission. The annual health check 2008/09. Assessing and rating the NHS. London (GB): Healthcare Commission; 2008 Jun [cited 2009 Nov 11]. Available from: http://www.cqc.org.uk/guidanceforprofessionals/healthcare/nhsstaff/annualhealthcheck2008/09.cfm.

12.

Department of Health, NHS Finance Performance and Operations. Operational plans 2008/09–2010/11 (implementing the 2008/09 operating framework). National planning guidance and “vital signs” [Internet]. London (GB): Department of Health; 2008 Jan 31 [cited 2009 May 27]. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_082542.

13.

Department of Health–World Class Commissioning. Commissioning assurance handbook, 2008 [Internet]. London (GB): Department of Health; 2008 Jun 4 [cited 2009 Aug 17]. Available from: http://www.dh.gov.uk/en/Managingyourorganisation/Commissioning/Worldclasscommissioning/Assurance/index.htm.

14.

Department of Health–World Class Commissioning. World class commissioning assurance handbook. Year 2 [Internet]. London (GB): Department of Health; 2009 Sep 16 [cited 2009 Oct 17]. Available from: http://www.dh.gov.uk/en/Managingyourorganisation/Commissioning/Worldclasscommissioning/Assurance/index.htm.

15.

Care Services Improvement Partnership, National Institute for Mental Health England. DRE Programme. Delivering Race Equality (DRE) Dashboard [Internet]. London (GB): Department of Health; 2008 Sep 15 [cited 2009 Jun 15]. Available from: http://www.northeast.csip.org.uk/silo/files/dre-dashboard.pdf.

16.

Healthcare Commission, Commission for Social Care Inspection. No voice, no choice. A joint review of adult community mental health services in England [Internet]. London (GB): Healthcare Commission; 2007 Jul [cited 2009 May 8]. Available from: http://www.cqc.org.uk/_db/_documents/Community_mental_health_-_full_report.pdf.

17.

Healthcare Commission. Commission for Social Care Inspection. Joint Community Mental Health Services review. Summary of the scored assessment framework [Internet]. London (GB): Healthcare Commission; [date of publication unknown] [cited 2009 May 11]. Available from: http://cpaa.org.uk/files/summary_scoring_framework_Joint_Review_Community_Mental_Health.pdf.

18.

Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde. Leitlinien für Diagnostik und Therapie—Psychiatrie/Psychotherapie/Nervenheilkunde [Internet]. Düsseldorf (DE): AWMF Online; [date of publication unknown] [cited 2009 Dec 21]. Available from: http://www.uni-duesseldorf.de/AWMF/ll/ll_038.htm. Short version. German.

19.

Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde. S3-Leitlinie/Nationale VersorgungsLeitlinie. Unipolare Depression, Langfassung, Dezember 2009 [Internet]. Berlin (DE): Ärztliches Zentrum für Qualität in der Medizin; 2009 Dec [cited 2009 Dec 21]. Available from: http://www.versorgungsleitlinien.de/themen/depression/pdf/s3_nvl_depression_lang.pdf. German.

20.

Gaebel

Janssen

Zielasek

Mental health quality, outcome measurement, and improvement in Germany. Curr Opin Psychiatry. 2009;22:636–642.

21.

Gaebel

Janssen

Benchmarking in der psychiatrischen Akutbehandlung—Ein Modellprojekt im Klinikverbund. [Internet]. Köln (DE): Landschaftsverband Rheinland–Dezernat Gesundheit, Heilpädagogische Netzwerke; [date of publication unknown] [cited 2009 Dec 21]. Available from: http://www.benchmarking-qm.de/FachThema/Projekte/Akutbehandlung. German.

22.

Kleudgen

Diel

Burgdorf

. KBV entwickelt Starter-Set ambulanter Qualitätsindikatoren, Ergebnisse des Projektes AQUIK—Ambulante Qualitätsindikatoren und Kennzahlen. [Internet]. Berlin (DE): Kassenärztliche Bundesvereinigung; 2009 [cited 2009 Dec 21]. Available from: http://www.kbv.de/qep/aquik.html. German.

23.

Szecsenyi

Stock

Broge

Quality indicators of the AOK für doctors nets. Z Managed Care Care Manage. 2003;6:18–20.

24.

Weinmann

Becker

. Qualitätsindikatoren für die Integrierte Versorgung von Menschen mit Schizophrenie. Bonn (DE): Psychiatrie-Verlag; 2009. German.

25.

Mental Health Commission. Quality framework. Mental health services in Ireland [Internet]. Dublin (IE): Mental Health Commission; 2007 [cited 2009 Jun 30]. Available from: http://www.mhcirl.ie/Standards_Quality_Assurance/Quality_Framework.pdf.

26.

Mental Health Commission. Quality framework for mental health services in Ireland. Draft audit toolkit [Internet]. Dublin (IE): Mental Health Commission; 2007 Mar [cited 2010 Jan 14]. Available from: http://www.mhcirl.ie/documents/publications/Quality%20Framework%20for%20Mental%20Health%20Services%20in%20Ireland%20Draft%20Audit%20Toolkit%202007.pdf.

27.

Headquarters for Mental Health and Welfare–Ministry of Health, Labour and Welfare. A vision for mental health and welfare reform [Internet]. Tokyo (JP): Ministry of Health, Labour and Welfare; 2004 Sep [cited 2009 Jan 23]. Available from: http://www.ncnp.go.jp/nimh/keikaku/vision/e7.html.

28.

Ito

Quality and performance improvement for mental healthcare in Japan. Curr Opin Psychiatry. 2009;22:619–622.

29.

GGZ Transparency Steering Group. Basic set of performance indicators for mental health care and addition care 2007–2008. Den Haag (NL): Health Care Inspectorate; 2007.

30.

Steering Committee Responsible Care. Quality framework responsible care—nursing, care, and home care. Den Haag (NL): Health Care Inspectorate; 2008 May.

31.

McKenzie

Aimer

Grady

. Report on the Key Performance Indicator Framework for New Zealand Mental Health and Addiction Services [Internet]. Manukau (NZ): Counties Manukau District Health Board; 2007 Nov [cited 2009 Feb 17]. Available from: http://www.sah.co.nz/Funded-Services/Mental-Health/Projects/KPIframework/default.htm.

32.

Mental Health Commission. Blueprint for mental health services in New Zealand—how things need to be. Wellington (NZ): Mental Health Commission; 1998 Dec.

33.

Welsh

Kokaua

New Zealand District Health Board Mental Health Service Profile. Benchmarking. 2005;12(6):508–514.

34.

National Directorate for Health and Social Affairs. 2005, … and it's going to get better! National strategy for quality improvement in health and social services (2005–2015) [Internet]. Oslo (NO): National Directorate for Health and Social Affairs; 2005 Sep [cited 2009 Dec 28]. Available from: http://www.helsedirektoratet.no/selectedtopics/quality_improvement.

35.

The Norwegian Directorate of Health. Nasjonalt indikatorsett psykisk helsevern [National indicators of mental health services] [Internet]. Oslo (NO): The Norwegian Directorate of Health; 2008 Dec 18 [cited 2009 Dec 28]. Available from: http://www.helsedirektoratet.no/kvalitetsforbedring/kvalitetsindikatorer/psykisk_helsevern_14591. Norwegian.

36.

Coia

Glassborow

Mental health quality and outcome measurement and improvement in Scotland. Curr Opin Psychiatry. 2009;22:643–647.

37.

Coia

Anderson

Dutta

. Mental health project final report: National benchmarking project. Report 2 [Internet]. Edinburgh (GB): NHS Scotland; 2008 Jan [cited 2009 Jun 30]. Available from: http://www.scotland.gov.uk/Publications/2008/01/22113703/0.

38.

Coia

Anderson

Dutta

. Mental health benchmarking project. Technical appendix, November 2007 [Internet]. Edinburgh (GB): NHS Scotland; 2008 Feb [cited 2009 Jun 30] Available from: http://www.scotland.gov.uk/Publications/2008/02/14130033/0.

39.

Hunter

Cameron

Norrie

Using patient-reported outcomes in schizophrenia: The Scottish Schizophrenia Outcomes Study. Psychiatr Serv. 2009;60(2):240–245.

40.

Herbstman

Pincus

. Measuring mental healthcare quality in the United States: A review of initiatives. Curr Opin Psychiatry. 2009;22:623–630.

41.

Abt Associates Inc. National nursing home quality measures. User's manual. Version 1.2 [Internet]. Washington (DC): US Department of Health and Human Services, Centers for Medicare and Medicaid Services; 2004 Nov [cited 2009 Oct 16]. Available from: http://www.cms.hhs.gov/NursingHomeQualityInits/downloads/NHQIQMUsersManual.pdf.

42.

Horovitz-Lenon

Watikins

Pincus

. Working paper. Veterans Health Administration Mental Health Program Evaluation technical manual. [place of publication unknown]: RAND Health; 2009 Feb [cited 2009 May] Available from: http://www.rand.org/pubs/working_papers/WR682/.

43.

Agency for Healthcare Research and Quality, US Department of Health and Human Services. Consumer Assessment of Healthcare Providers and Systems (CAHPS). Experience of Care and Health Outcomes (ECHO) Survey [Internet]. Rockville (MD): Agency for Healthcare Research and Quality; [date of publication unknown] [cited 2009 Oct 16]. Available from: http://www.cahps.ahrq.gov.

44.

Ganju

Adams

Bartels

. Recommended operations definitions and measures to implement the NASMHPD framework of mental health performance indicators (draft 4) [Internet]. Alexandria (VA): NASMHPD; 2000 Dec [cited 2009 Oct 16]. Available from: http://www.nri-inc.org/reports_pubs/2001/PresidentsTaskForce2000.pdf.

45.

American Medical Association. Physician Consortium for Performance Improvement (PCPI) [Internet]. Chicago (IL): AMA; [date of publication unknown] [updated 2010 Jan; cited 2009 Oct 16]. Available from: http://www.ama-assn.org/ama/pub/physician-resources/clinical-practice-improvement/clinical-quality/physician-consortium-performance-improvement/pcpi-measures.shtml.

46.

National Committee for Quality Assurance. Health Plan Employer Data and Information Set (HEDIS) [Internet]. Washington (DC): National Committee for Quality Assurance; 2010 [cited 2009 Oct 16]. Available from: http://www.ncqa.org/tabid/59/Default.aspx.

47.

Herbstman

Pincus

. Measuring mental healthcare quality in the United States: A review of initiatives. Curr Opin Psychiatry. 2009;22:623–630.

48.

Hermann

Mattke

, and the members of the OECD Mental Health Care Panel. Health technical papers no 17. Selecting Indicators for the quality of mental health care at the health system level in OECD countries [Internet]. Paris (FR): OECD; 2004 Oct 28 [cited 2009 Jun 30]. Available from: http://www.oecd.org/dataoecd/28/32/33865630.pdf.

49.

National Research and Development Centre for Welfare–Health STAKES. Establishment of the indicators for mental health monitoring in Europe [Internet]. Helsinki (FI): National Institute for Health and Welfare; 2002 Feb [cited 2009 Mar 16]. Available from: http://groups.stakes.fi/MTR/EN/projects/past/mhindicators.htm.

50.

World Health Organization. Assessment Instrument for Mental Health Systems. WHO–AIMS, version 2.2. Geneva (CH): WHO; 2005.