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In Reply to: Re: What and how do you think things need to change? posted by moonshiner on February 28, 2006 at 11:07:44:
In my state, we (meaning, the people I work with) struggle quite a lot with treatment providers who argue against measuring treatment outcomes because therapy is an "art" and therefore can't be properly evaluated. I have always maintained that art can be evaluated by some mutally agreed-upon measure of aesthetics and so can therapy. It's just a matter of determining what is a fair measure, which is something that can be done by reasonable people through a consensus process.
When it comes to therapy, we (the state's Dept. of Mental Health and it's constituents, particulary consumers of services) have determined that the "art" of mental health (MH) therapy can be measured in several ways: 1) Does the consumer of MH services experience a reduction in symptoms or increased capacity to manage symptoms? 2) Does the consumer of MH services experience better personal and social functioning? 3) Does the consumer of MH services feel empowered to take charge of his/her lot in life and/or more hopeful about his/her situation? 4) Does the consumer of MH services report a better quality of life as a result of treatment?
Simple concepts, but oh-so-hard to get the front line providers of MH services to understand and value. Yes, there are MH treatment providers who don't give a rat's ass about people getting better and moving on with their lives. Such service providers are primarily interested in garnering payment for MH services that keep people coming back and not getting better. Keep a sick person dependent on you for poorly treated mental illness, and guess what? You're milking a cash cow at insurance company & taxpayer expense.
I feel more than just a little bit defensive about measurable outcomes to therapy because I have to go out and fight s battle for a transformation of in the MH system of care on a daily basis.
GOOD NEWS! The National Association for the Mentally Ill (NAMI) did a scorecard of the 50 US states, and my state ranked number 1 with a grade of "B". The second-ranked state received a B-. That should tell you something about how far we (in the US) need to go. I'm happy my state has been top-ranked by a national consumer organization, but not happy that we are delivering a quality of care to the average Joe that is less than the highest level of excellence due.
