Current practices for measuring mental health outcomes in the USA: International overview of routine outcome measures in mental health

The prevalence and impact of mental health conditions calls for measuring the adequacy of care, but progress in measuring mental health outcomes in the USA has been uneven, with some important domains (such as employment and other measures of everyday functioning) rarely captured. Bright spots include progress in adopting uniform measures of the quality of inpatient mental healthcare and early progress in measuring adequacy of medication and psychotherapy treatment. To some extent, progress in measurement has been limited by separate governing structures and payment rules in mental health and overall health settings. This is becoming a critical problem as awareness of the scope and impact of mental health co-morbidities emerges at the same time as pressures for healthcare cost controls intensify. A search for better measures may be accelerated as problems linked to co-morbid mental health problems (e.g. readmission to hospitals) come into sharper focus due to changes in healthcare financing related to the US Patient Protection and Affordable Care Act, 2010.