In today's world, taking care of your mental health is more important than ever, and making sure everyone gets the quality care they deserve is key. Employers and health plans are starting to see that just offering mental health services isn't enough — these services need to truly make a difference in people's lives and the well-being of communities. By focusing on high-quality solutions, organizations and health plans can offer efficient, effective, and transformative support to their members. 

Quality in general healthcare 

Over the past several decades, there has been a significant shift towards prioritizing quality within general healthcare.  Moves towards value-based payment models and advancements in technology have made quality assurance and measurement a central focus among hospitals, health systems, and health plans. In this evolving landscape, healthcare organizations have more incentive to ensure quality — and they now have the data and tools to track outcomes more accurately. 

Quality in general healthcare is defined as the degree to which the healthcare services provided to individuals and populations improve health outcomes. Across the healthcare industry, quality means: 

• Safety: Minimizing risks and harm to patients, including preventing errors in care delivery.
• Effectiveness: Providing care based on scientific knowledge to achieve the best possible outcomes.
• Patient-centeredness: Delivering care that respects and responds to individual patient preferences, needs, and values, ensuring that patient values guide all clinical decisions.
• Timeliness: Reducing delays in receiving and providing care, which can affect health outcomes.
• Efficiency: Using healthcare resources wisely to avoid waste, including time, money, and supplies.
• Equity: Ensuring that care quality doesn't vary because of personal characteristics such as gender, ethnicity, geographic location, or socioeconomic status.

While general healthcare has made big strides, the same level of definition and alignment on quality hasn’t quite occurred within mental health.

The challenge with quality in mental health 

Unlike general healthcare, mental healthcare faces unique challenges in measuring and ensuring quality, such as: 

• The subjective nature of mental health: Unlike a physical condition such as diabetes where A1C levels can be defined and measured over time, mental health needs and improvement are often subjective and difficult to quantify. Historically, mental health assessments relied heavily on qualitative data like patient self-reports and clinician observations. The subjectivity and lack of consistency in these types of data can lead to variability in the standards of care across different providers and settings, leading to inconsistent treatment quality. Without standardized guidelines and quality control measures, patients might receive care that isn’t evidence-based or tailored to their specific needs.
  
  
• Stigma: Stigma may lead individuals to underreport or minimize their symptoms. This can result in incomplete assessments and gaps in data. Societal stigma can also affect mental health funding decisions, leading to insufficient resources being allocated to mental health services. This can result in overcrowded facilities, longer wait times, and limited availability of specialized treatments, all of which negatively impact the quality of care.
  
  
• Fragmentation: Mental healthcare can be frequently disconnected. A person might seek talk therapy from an out-of-network therapist, medication management from their primary care doctor, and group care services through a local support group. This fragmented experience, where there’s no  communication, isn’t an uncommon scenario. This can lead to gaps in care, duplicated treatments, inconsistent or conflicting advice, and a disjointed experience. In fact, poor care coordination can lead to higher rates of hospitalizations and emergency room visits for mental health crises.
  
  
• Shortage of Mental Health Professionals: There is a significant shortage of trained mental health professionals, including psychiatrists, psychologists, and counselors. This limits the availability of services and can lead to burnout among existing providers, further reducing the quality of care.
  
  
• Cultural and Linguistic Barriers: Cultural differences and language barriers can impede effective communication between patients and providers, leading to misunderstandings, misdiagnoses, or culturally insensitive care. 

What happens when quality isn’t prioritized?

Not measuring or investing in improving the quality of mental healthcare can have serious consequences. Without quality measurement and assurance, mental health providers might miss symptom deterioration, practice ineffective care, or fail to deliver evidence-based interventions, leading to prolonged suffering for individuals. Plus, without quality measurement, it can be tough to identify best practices and scale successful interventions. 

A limited focus on quality can get in the way of patient-centered mental healthcare.

Ensuring quality in mental healthcare

Even though quality in mental healthcare is different from  general healthcare — and might never be as straightforward — there are steps we can take to make sure we’re delivering quality care. 

To bring high-quality mental healthcare for their members, employers and health plans should evaluate whether their mental health solutions and Employee Assistance Programs (EAPs) are prioritizing key practices throughout their care operations such as: 

• Hiring the right providers: A rigorous vetting process is crucial when hiring. It's important to assess candidates' qualifications, experience, and expertise in evidence-based interventions. Hiring a diverse group of mental healthcare providers ensures that care is culturally responsive, inclusive, and aligns with the diverse experiences and backgrounds of members. 
• Ongoing training: Deep and consistent education on evidence-based interventions is crucial. Continuous training equips mental health professionals with the latest strategies and tools so that they are well-prepared to meet individual’s' evolving needs. Training on culturally responsive care is also essential to help providers understand and address the diverse cultural, linguistic, and social factors that can influence mental health, helping them deliver more effective and personalized care.
• Measurement-based care: Empowering providers to practice measurement-based care is essential. By routinely collecting member symptom assessment data, such as PHQ-9 or GAD-7, providers can review changes in member symptoms and adjust care plans. This data collection fosters a culture of accountability and responsiveness that enhances treatment effectiveness.
• Quality assessment embedded into care: It’s vital to routinely assess the quality of providers through key performance metrics. Monitoring member symptom improvement, length of stay, graduation rates, and member satisfaction rates creates a feedback loop that helps identify areas for enhancement and rewards successes in treatment. 
• Creating a collaborative system of care: Encouraging collaboration among care providers is necessary. Implementing a shared Electronic Health Record streamlines communication and data sharing between care providers, empowering them to seamlessly share insights and deliver dynamic care plans. Solutions should also create multidisciplinary consultation groups to allow providers to benefit from collective expertise, creating a collaborative learning environment. 

Quality at Headspace

Quality care is a key pillar of the Headspace model. We maintain rigorous standards across every aspect of our operations, from the hiring process to ongoing training and performance measurement. Our holistic approach consistently translates into meaningful outcomes for our members, including: 

• 85% of members engaged in Headspace’s coaching and clinical services experienced improvement in depression symptoms after 6-16 weeks
• 83% of members engaged in Headspace’s coaching and clinical services of members experienced improvement in anxiety symptoms after 6-16 weeks
• Our results from a published study showed that members engaging in care with a coach and/or clinician on average experienced an increase of 3 healthy and productive days after 30 days, as measured by the CDC Healthy Days assessment, a validated health-reality quality of life (HRQoL) measure. 
• In a cost of care analysis for a large pharmaceutical company, Headspace’s team-based care model delivered 15% savings for members engaged in coaching and clinical services. Headspace also delivered consistently lower spend across Cancer, Maternity, Musculoskeletal, and Metabolic Health compared to benchmark for a large pharmaceutical company. 

At Headspace, delivering quality care isn’t just a goal—it's our promise. To learn more about our quality approach, check out our white paper. We encourage you to see how our unique approach can help deliver better outcomes for your members. Together, let's create a future where quality mental healthcare makes a real difference in people's lives.

‍