A Patient-Centered Outcomes Framework for Evaluating Behavioral Health Crisis Care

Area of Science:

• Health Services Research
• Mental Health Services
• Quality Improvement

Background:

• Federal investments are transforming the behavioral health crisis care (BHCC) system nationwide.
• There is a growing need for data and defined outcomes to assess BHCC quality and effectiveness.
• Identifying patient-centered outcomes (PCOs) is crucial for evaluating system performance.

Purpose of the Study:

• To identify patient-centered outcomes (PCOs) for behavioral health crisis care (BHCC).
• To gather perspectives from individuals with lived experience and BHCC service providers.
• To develop a framework for assessing BHCC quality.

Main Methods:

• Qualitative interviews were conducted with 120 stakeholders, including peers with lived experience, direct-service providers, program managers, and executive leaders.
• An open coding approach was used to analyze interview transcripts and identify emerging themes.
• Themes were mapped to Donabedian's structure-process-outcome model to develop a PCO framework.

Main Results:

• Forty-five themes related to BHCC were identified.
• Themes were categorized into five domains: system structure, system implementation, system use, social outcomes, and health outcomes.
• A PCO framework for evaluating BHCC was developed.

Conclusions:

• The developed framework serves as a starting point for patient-centered outcome research in BHCC.
• Further engagement with patients and providers is needed to develop specific measurement tools.
• This framework can guide efforts to improve the quality and effectiveness of BHCC services.