Physical Health Has Its Yardsticks. Mental Health Is Still Searching for the Right Ruler

While doctors can track cancer progression at the cellular level or use a blood test to obtain precise blood cholesterol levels, talk therapy’s impact on mental health is still largely reliant on gut feelings more than hard data.

A national initiative led by the National Institute of Mental Health is now underway to find figurative “rulers” that can accurately measure and compare the quality of the various mental health treatments available. To lead off this effort, UCLA Health researchers were awarded a four-year, $2.1 million federal grant to study and test whether such a quality measure can be created and applied across all social groups in the United States.

“We have so many problems with mental health in this country that are only getting worse,” said Dr. Alexander Young, professor at UCLA Health’s Department of Psychiatry and Biobehavioral Sciences. “We really need to be able to provide access to high quality care for all the diverse populations that we serve.”

Demand for mental health care in America has soared in recent years, with a majority of psychologists reporting having waiting lists for new patients, according to a recent survey by the American Psychological Association. Meanwhile, more treatment options are available including numerous evidence-based psychotherapies, neuromodulation including Transcranial Magnetic Stimulation, new medications and telehealth services among others. 

While some larger health care providers have made efforts to address the issue, the effectiveness and quality of these treatments have generally not been accurately monitored at a national level , resulting in a scarcity of clinical data on patient outcomes, Young said. 

As a result, governmental organizations, provider organizations, insurance companies, patients and families have little information to gauge the quality of the mental health services they are supporting or receiving, Young said.

As part of a national initiative, UCLA researchers will aim to create accurate quality measurement based on routine, regular patient reports of their symptoms. To develop and test this, Young and his colleagues will utilize a unique database of more than 5 million symptom assessments from 500,000 patients collected during mental health treatment. The data are being analyzed in conjunction with the ACORN Collaboration, an international consortium that includes mental health and substance abuse treatment centers. 

One important aspect of the project will work to ensure that the quality measure supports improvement in socioeconomic disparities in both the access to and quality of mental health treatment.

“We need to come up with a measurement that's consistent across social groups and accurate given the diversity of people and situations in the United States,” Young said.

Other collaborators in the study from UCLA include Li Cai, Nick Jackson, April Thames and Lucinda Leung.