One in five adults – nearly 58 million Americans – live with a mental health condition, with anxiety and depression rates at an all-time high. Even with access to mental health care improving, only 13 percent of patients with access to care report lasting improvement.
Access to care is no longer our biggest hurdle when tackling the mental health crisis, but rather ensuring those in need have access to high-quality and data-driven care. But what does that look like?
The mental health care industry has traditionally lacked technology solutions to track data to measure and improve the effectiveness of treatment over time, forcing clinicians to largely rely on subjective trial-and-error.
To better address the growing mental health crisis, providers need to align on what high-quality care looks like and how to measure data-driven and outcomes-focused effectiveness across a wide range of organizations, populations, treatment settings, and more.
That’s why we are excited to introduce the Blueprint Quality Index (BQI) - the first-ever national benchmark standards of care, offering clinicians an industry standard to measure the efficacy of treatment and improve patient outcomes. The Blueprint Quality Index (BQI) represents what we believe to be a critical first step in establishing transparent benchmarks in behavioral healthcare to help communicate, compare, and improve outcomes at the national level.
The Blueprint Quality Index (BQI) was generated from over 2.5 million outcome measures from report findings from 200,000 patients across more than 2,000 mental health organizations. This data set is 50 times larger than the most well-known and largest behavioral health clinical study from 2008, STAR*D, making it the most robust, most distributed, and highest-fidelity mental health report in United States history.
Through our data repository, we found that the current quality of mental health care varies widely. An average of two-thirds (66%) of people who begin a 12-week course of outpatient behavioral health services do not reach remission for anxiety or depression. Roughly four out of five patients do not experience any clinically meaningful response to therapy, regardless of their remission status.
Our report also found:
- Approximately 21% of patients experience clinically meaningful improvements in depression symptoms and 24% in anxiety symptoms within 12 weeks of care.
- Only 31% of patients achieve remission for their depression symptoms during outpatient therapy, and 38% experience remission of anxiety symptoms.
- Clinical response to outpatient behavioral health care was greatest among high-severity patients (65% for depression, and 44% for anxiety) and smallest among mild-severity patients (16% for anxiety and depression).
Through these findings, we developed the BQI, the industry’s first set of benchmarks for quality care. By scoring mental health organizations based on a scale (0-100) for anxiety and depression outcomes, we’re creating clear referable standards for clinicians and organizations to improve communication, standards of care, and patient outcomes nationwide.
As insurance companies move toward performance-based payment structures, smaller organizations who historically struggle to adopt enterprise-relevant quality measures (e.g. HEDIS) may in the future be able to use the BQI as a more scalable and equitable measure of quality outcomes within a network or population of interest. Aspirationally, we hope that the continued development, refinement, and dissemination of this benchmarking methodology will eventually help consumers better choose and receive the highest quality of care possible for them.
Clinicians around the country are already putting the BQI to practice. Here’s what Melissa Bartholomew, LMHC, owner of mental health practice Brighter Bound, had to say:
"Demand for mental health care continues to skyrocket and clinicians need measurement-based tools to ensure treatment is actually creating lasting patient improvement. As someone who has seen the effectiveness of Blueprint’s benchmark program firsthand, I view these benchmarks as an essential tool in helping me achieve the best clinical outcomes with my clients and fully support and encourage the industry-wide adoption of these standards. For the first time, my fellow clinicians have a roadmap to create more personalized treatment plans that will help patients get better, faster.”
The need for industry benchmarks is not novel. In fact, healthcare at large already uses a benchmarking method to assess quality of care, referred to as Achievable Benchmarks of Care (ABCs), which derives a standard of excellence based on existing data from top performers in a given peer group.
As an industry, we're long overdue to set the same standards for behavioral health care. We urge mental health clinicians and organizations that are not currently systematically measuring their outcomes to begin to do so, and behavioral healthcare organizations that are measuring outcomes embrace a culture of transparency and quality improvement.
The wide adoption of systematic metrics of care will have a profound, positive impact on the mental healthcare industry. But by instituting unprecedented transparency and measurement into our approach to mental healthcare, we will ensure the most effective treatments are highlighted throughout the industry and increase access to quality care while saving countless lives.
