JMIR Publications

ABSTRACT

Introduction: The ongoing mental health crisis, especially among youth, has led to a greater demand for intensive treatment at the intermediate level, like Intensive Outpatient Programs (IOPs). Understanding best practices within IOPs, particularly virtual-first programs, is crucial. Measurement-Based Care (MBC), which involves gathering and utilizing patient-reported data to tailor treatment, is one such practice. Despite literature linking MBC to beneficial clinical outcomes, the adoption of MBC in clinical practice has been slow and inconsistent, and more research is needed around MBC in youth-serving settings. This manuscript helps bridge these gaps, illustrating the implementation of MBC within an organization that provides virtual-first, youth-oriented IOP services for individuals with high-acuity psychiatric needs. Intervention: Two quality-improvement MBC pilots were conducted with select clinicians and their clients at Charlie Health, a virtual IOP program that treats high-acuity teens and young adults who present with a range of mental health disorders. Both pilots were carefully designed, including thorough preparation and planning, clinician training, and feedback collection. Using process evaluation data, MBC deployment was repeatedly refined to enhance the clinical workflow and clinician experience.

Results:

Data supported strong MBC implementation success. Specifically, survey completion was 80% and 86% for pilot V1 and V2, respectively, and quantitative clinician feedback showed marked improvement from pilot V1 to pilot V2. Clients who participated in the MBC pilots showed improved clinical outcomes compared to clients who did not. Depression, anxiety, and psychological well-being symptom reduction from intake to discharge was significantly greater for clients in the MBC pilots, as well as their likelihood of discharge due to successful treatment completion. Discussion: Findings support both feasibility and clinician acceptability of a rigorous MBC process in a real-world youth-serving, virtual-first intermediate care setting. Further, client outcomes data provide support for the efficacy of MBC as compared to usual practice. High survey completion rates across both pilots and improved clinician feedback over time supports strong initial clinician adherence and preliminary support for client and clinician buy-in. This manuscript provides practical guidance for MBC implementation in IOP programs, and can extend to other virtual mental health care settings.