Introduction
An ability to measure progress and record positive patient outcomes is a game-changer in behavioral health care. Measurement-based care (MBC) or Measurement-Based Behavioral Health is one of the most appealing methods that applies data-driven instruments to measure mental health improvement and personalize care. Combined with one of the models of well-being created by psychologist Martin Seligman, the PERMA model, MBC can produce a systematic, efficient approach to improving mental health care. The given blog discusses how the measurement tools have been used to facilitate the PERMA components (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) and provides practical tips to guide healthcare technology professionals, doctors, and nurses.
What Is Measurement-Based Care?
Measurement-Based Behavioral Health is the employment of uniformly applied instruments, such as questionnaires or digital monitors, in measuring the symptoms and condition of a patient, and treatment outcomes or progress. They offer objective data, e.g., PHQ-9 in the case of depression or GAD-7 in the case of anxiety, that a clinician can use to make real-time changes to treatment. In healthcare technology, MBC presents an opportunity to develop technology that will help professionals collect data at ease and translate it into action. In the case of doctors and nurses, it can serve as a means of basing decisions on evidence so that any given treatment is unique and successful.
MBC is not all about getting the numbers. It is about knowing the patient and implementing data in directing care. Together with the PERMA model that concentrates on five pillars of well-being, MBC can be a potent method to approach mental health comprehensively.
How Measurement-Based Care Supports PERMA
Now, we can discuss how MBC fits into each of the PERMAs via the implication of healthcare professionals.
1. Positive Emotion
The mental health recovery depends on positive emotions, such as happiness or calmness. An example of an MBC tool would be mood-tracking apps or survey instruments such as the Positive and Negative Affect Schedule (PANAS) to allow clinicians to quantify a patient’s emotional state over a period of time. To illustrate, a depressed patient may sign in to a mobile app to rate his/her mood every day. The information allows physicians to notice trends–perhaps the patient is more cheerful during and after therapy sessions or on some particular days–and make changes to medical procedures such as drugs or counseling.
To Tech Professionals: Develop ease-of-use applications that will remind patients to record their mood on a daily basis. Allow its use using basic interfaces, sliders, or emojis to make it easy even when a user has low energy levels or even motivation. Make the data easy to read (e.g., graphs displaying the change in mood) in order to enable clinicians to take prompt action.
Check the mood analytics prior to the appointment or meeting with Doctors and Nurses to ask specific questions, such as, “I see you were having a down mood last week or the week before, what was happening then?” This helps to develop trust and tells the patient that you are listening to him.
2. Engagement
Engagement refers to making patients find something to do that engulfs them, whether that thing is hobbies or mindfulness practices. Engagement can be tracked with Measurement-Based Behavioral Health using such tools as the State Flow Scale or even wearable gadgets tracking the activity level. As an example, an anxious patient may keep track of how much time he/she spend on relaxing activities, such as meditation, with a smartwatch. Clinicians will then be able to observe whether such activities have any correlation with a decreased level of symptoms.
To Tech Professionals: Create wearables or apps with the capability to monitor how much time is involved with the engaging actions, but not invasive. Put a little ‘gamification twist to it, perhaps reward regular practice of meditation through, say, a badge offered to the patient, to incentivize them to stick with it.
To the Doctors and Nurses: Engagement information can be used to provide recommendations for the patient. In case a patient likes to paint but has not painted recently, propose simple steps of re-introducing activities, such as a 10-minute sketching.
3. Relationships
Good social relations are important to health. MBC tools have the capacity to determine the quality of relationships by conducting surveys such as the Social Connectedness Scale. Such instruments inquire about how they engage with family, friends, or support groups, exposing their strengths or isolation levels. As an illustration, a patient will indicate that he feels disconnected; this should lead to the recommendation of group therapy by a clinician.
To Tech Professionals: Develop a platform that can be synced to a telehealth system, so that the patient can record his/her social life or be able to attend a virtual support group. Security and privacy are important to establish trust since patients might not have the comfort of divulging personal information.
Physicians and Nurses: Priming information on relationships to use in the discussions. In case of poor social support in the survey of a patient, discuss barriers (e.g., shyness or logistical barriers) and propose some helpful ideas, e.g., meet-ups near the place of living.
4. Meaning
Mental health recovery can be fixed with a purpose. MBC tools enable clinicians to measure the extent to which a patient derives meaning in his/her daily life, e.g., in purpose-in-life questionnaires. An example would be that a PTSD veteran receives a survey that indicates low purpose, and a conversation on the idea of volunteering is discussed.
To Tech Professionals: Create tools where patients have an opportunity to reflect on meaning by filling in guided questions, such as, “What made you feel contented today?” Study answers and pinpoint trends with AI, and present them to clinicians, freeing them from work.
To Doctors and Nurses: Asking patients what brings their life meaning should be a basis for survey data. Recommend little steps, such as writing about values or being part of a community project, to create purpose.
5. Accomplishment
The accomplishment of even the smallest objectives augers well for confidence and motivation. MBC is capable of monitoring achievements using goal-setting applications. As an example, a social anxiety patient would want to attend a social event as one of his goals. An app might follow their progress and remind them, and the data are also reviewed by the clinicians to celebrate successes.
In the case of tech professionals, create the apps that will allow the patients to set and monitor micro-goals and remind them to stay encouraged. Put some form of progress visualization (such as a completion bar) to give the sense of achievements being tangible.
On Doctors and Nurses: Celebrate achievements with patients (and use data to show progress). In case a patient fulfilled a goal, such as exercising twice a week, reward them and establish a new but slightly larger goal.
The Future of MBC and PERMA
Measurement-based care, when paired with the PERMA model, will help medical professionals develop a more comprehensive, evidence-based direction of mental health. This is possible due to the technology that will streamline the process of data collection and analysis, and a human touch provided by clinicians that will turn care into a meaningful experience. All these initiatives, when aggregated, have the potential to improve patient outcomes and lead to an expansion of access and utilization of mental health care.
References
- Seligman, M. E. P. (2011). Flourish: A Visionary New Understanding of Happiness and Well-being. Free Press.
- Fortney, J. C., Unützer, J., Wrenn, G., et al. (2017). A tipping point for measurement-based care. Psychiatric Services, 68(2), 179–188.