This innovative monograph introduces a measurement-based framework for effective treatment of patients with mood disorders, personality disorders, and schizophrenia. Rooted firmly in principles of pharmacotherapy and clinical psychometrics, the book’s signature diagram balances rating scale results and patient self-reported progress along three angles: therapeutic effects, adverse effects, and quality of life. The author’s choices of measures are brief, valid, widely used, and easy for clinicians to administer and patients to understand. But rather than being a mechanistic or an impersonal formula, this system is shown as a science-based means of fostering constructive collaboration between patient and therapist, leading to greater patient well-being. Included in the coverage: · Negative mental health: the ordinary symptom-orientated mental disorders. · The basic diagram of personality dimensions. · Self-reported symptom scales within the basic diagram. · Clinician-administered symptom scales within the basic diagram. · The pharmacopsychometric triangle in measurement-based care. · Diagnostic rating scales. · A practical outcome evaluation plan. Offering a medical level of precision to mental health, Measurement-Based Care in Mental Disorders should interest health care providers at all levels, particularly physicians and staff in primary care settings, and in psychiatric in- and outpatient clinics, including psychiatrists, psychologists, nurses, and social workers.

The first book to focus on measuring the basic processes of mental healthcare, such as access, detection, treatment appropriateness, safety and continuity of care, Improving Mental Healthcare: A Guide to Measurement-Based Quality Improvement integrates practical information about quality measures -- such as their clinical logic, validity and basis in scientific evidence -- into a highly readable guide on how to implement measures and use the results to improve quality of care. Improving Mental Healthcare examines the clinical, policy, and scientific underpinnings of process measurement, a widely used method of assessing quality of mental healthcare. It describes the use of measurement to improve quality, promote accountability, encourage evidence-based practice, and shape incentives to favor delivery of high-quality care. Divided into two sections totaling 14 chapters, the first section describes factors that led to a nationwide emphasis on improving quality of care, major approaches to quality assessment, considerations in selecting measures, as well as how to analyze and interpret measure results. The second section summarizes information on more than 300 quality measures, including their clinical rationale, specifications, sources of data, supporting evidence, readiness for use, and -- where available -- data on reliability, validity, results, case-mix adjustment, standards, and benchmarks. Improving Mental Healthcare helps clinicians, managers, administrators, payers, purchasers, accreditors, consumer groups, and other stakeholders meet national mandates to assess and improve quality of care by providing the following tools and guidance: Results from the National Inventory of Mental Health Quality Measures, a federally funded study summarizing clinical, technical, and scientific properties of more than 300 process measures A user-friendly format that helps potential measure users find quality measures that reflect their priorities and meet their needs Guidance for healthcare organizations and clinicians on how to integrate measurement into a comprehensive approach to quality management An understanding of the relationship between process measurement and other approaches to quality assessment, in particular outcomes assessment-the focus of a companion guide, Outcome Measurement in Psychiatry: A Critical Review (APPI 2002) Improving Mental Healthcare, which includes extensive references as well as useful figures and tables illustrating key concepts, is essential reading for practicing clinicians, healthcare managers, medical students and psychiatric residents -- who must now meet ACGME requirements to learn about quality assessment and improvement -- as well as members of oversight organizations and consumer advocacy groups. It will prove invaluable for healthcare organizations seeking to improve quality of care, clinical training programs, and courses on quality assessment, healthcare management, and mental health policy.

Precision psychiatry, as outlined in this groundbreaking book, presents a new path forward. By integrating findings from basic and clinical neuroscience, clinical practice, and population-level data, the field seeks to develop therapeutic approaches tailored for specific individuals with a specific constellation of health issues, characteristics, strengths, and symptoms.

Psychiatric clinicians should use rating scales and questionnaires often, for they not only facilitate targeted diagnoses and treatment; they also facilitate links to empirical literature and systematize the entire process of management. Clinically oriented and highly practical, the Handbook of Clinical Rating Scales and Assessment in Psychiatry and Mental Health is an ideal tool for the busy psychiatrist, clinical psychologist, family physician, or social worker. In this ground-breaking text, leading researchers provide reviews of the most commonly used outcome and screening measures for the major psychiatric diagnoses and treatment scenarios. The full range of psychiatric disorders are covered in brief but thorough chapters, each of which provides a concise review of measurement issues related to the relevant condition, along with recommendations on which dimensions to measure – and when. The Handbook also includes ready-to-photocopy versions of the most popular, valid, and reliable scales and checklists, along with scoring keys and links to websites containing on-line versions. Moreover, the Handbook describes well known, structured, diagnostic interviews and the specialized training requirements for each. It also includes details of popular psychological tests (such as neuropsychological, personality, and projective tests), along with practical guidelines on when to request psychological testing, how to discuss the case with the assessment consultant and how to integrate information from the final testing report into treatment. Focused and immensely useful, the Handbook of Clinical Rating Scales and Assessment in Psychiatry and Mental Health is an invaluable resource for all clinicians who care for patients with psychiatric disorders.

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

Mental health and substance use disorders affect approximately 20 percent of Americans and are associated with significant morbidity and mortality. Although a wide range of evidence-based psychosocial interventions are currently in use, most consumers of mental health care find it difficult to know whether they are receiving high-quality care. Although the current evidence base for the effects of psychosocial interventions is sizable, subsequent steps in the process of bringing a psychosocial intervention into routine clinical care are less well defined. Psychosocial Interventions for Mental and Substance Use Disorders details the reasons for the gap between what is known to be effective and current practice and offers recommendations for how best to address this gap by applying a framework that can be used to establish standards for psychosocial interventions. The framework described in Psychosocial Interventions for Mental and Substance Use Disorders can be used to chart a path toward the ultimate goal of improving the outcomes. The framework highlights the need to (1) support research to strengthen the evidence base on the efficacy and effectiveness of psychosocial interventions; (2) based on this evidence, identify the key elements that drive an intervention's effect; (3) conduct systematic reviews to inform clinical guidelines that incorporate these key elements; (4) using the findings of these systematic reviews, develop quality measures - measures of the structure, process, and outcomes of interventions; and (5) establish methods for successfully implementing and sustaining these interventions in regular practice including the training of providers of these interventions. The recommendations offered in this report are intended to assist policy makers, health care organizations, and payers that are organizing and overseeing the provision of care for mental health and substance use disorders while navigating a new health care landscape. The recommendations also target providers, professional societies, funding agencies, consumers, and researchers, all of whom have a stake in ensuring that evidence-based, high-quality care is provided to individuals receiving mental health and substance use services.

Mental Health Outcome Measures provides an authoritative review of measurement scales currently available to assess the outcomes of mental health service intervention. The excerpt of summaries by leading writers in the field assess the contributions of scale in areas including mental state examination, quality of life, patient satisfaction, needs assessments, measurement of service cost, global functioning scales, and social disability. These chapters provide a critical appraisal of how far such scales have been shown to be reliable and valid, and provide valuable insights in to their ease of use. This book will provide an invaluable reference manual for those who want to take research on mental health services, and for those who need to interpret this research for policy, planning, and clinical practice.

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.