As the healthcare industry moves toward value-based, patient-centered care, measuring quality has become more important than ever. Although there have been important developments in general healthcare, the mental health field has lagged behind when it comes to adopting quality measures that improve health outcomes.

Headspace employs a measurement-based care approach, a gold standard to ensuring quality and delivering improved outcomes. Central to our care model is regular measurement of our members’ symptoms, functioning, and progress, which leads to more effective, personalized, and evidence-based treatment.

The importance of assessments in measurement-based care

Throughout the Headspace experience, members are prompted via the app and their care team to complete subclinical and clinical assessments to track symptom improvement and/or deterioration over time. These assessments are integral to painting a comprehensive picture of a member's mental health. It allows us to capture the nuances of each individual's experience, enabling Headspace coaches and clinicians to tailor interventions that are both timely and effective. By harnessing the insights from these assessments, we enhance the overall member experience and ensure our solutions are meeting the highest standards of quality.

The outcomes of these assessments are shared with members to help them understand their own treatment progress, and are also shared in aggregate and anonymously with our product, operations, research, and data science teams to support the implementation of new enhancements and improvements to the member experience. Finally, this aggregated and anonymized data is shared directly with employers to help them understand the overall health of their organization and make informed decisions on their mental health benefits strategy.

Let's dive deeper into some of the key assessments we use at Headspace:

• PHQ-4: The Patient Health Questionnaire 4 (PHQ-4) is a 4-question screening tool used to detect potential symptoms of anxiety and depression. It is a shortened version of the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7 (GAD-7) questionnaire. Members are prompted to take this at the beginning of their journey with Headspace. This baseline measure is used to point members to the right assessment for their level of need. 
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• PHQ-9: The PHQ-9 is a widely recognized tool for screening and measuring the severity of depression. Composed of nine questions, it asks members to reflect on their recent experiences and symptoms. This self-reported method offers a quick and effective way to understand a member's depressive symptoms, allowing for precise adjustments in their care plan. Members are prompted to take this assessment when they are engaged in Headspace coaching or clinical services.
  
  
• GAD-7: The GAD-7 is a commonly used assessment to measure and assess the presence and severity of anxiety symptoms. It provides a straightforward method for understanding how anxiety impacts a member's daily life. Members are prompted to take this assessment when they are engaged in Headspace coaching or clinical services. Members engaged in content only may also take this assessment at various points in their journey.
  
  
• PSS: The Perceived Stress Scale (PSS) is a widely used and validated 10-question assessment used to measure a member’s perception and experience of stress in their life. Members may take the PSS when engaging with Headspace content, clinical services, or coaching.
  
  
• C-SSRS: The Columbia Suicide Severity Rating Scale (C-SSRS) provides a thorough, reliable, and evidence-based method for evaluating a member’s exact level of suicide risk, allowing Headspace providers to deliver the most appropriate intervention and safety plan. A member is routed to the C-SSRS assessment experience based on their answer to question 9 on the PHQ-9 survey, which asks how often the member had thoughts that they “would be better off dead or of hurting yourself in some way.” If the member answers, “Nearly every day” or “More than half the days,” they are routed to the C-SSRS assessment. The results of this assessment are used to provide detailed information to our specially trained Risk Coaches.
  
  
• PROMIS-Sleep Disturbance Short Form 8a: This assessment evaluates self-reported perceptions of sleep quality, sleep depth, and restoration associated with sleep. Members may take this assessment when engaging in our Guided Program for Sleep.

What value do assessments provide?

Importantly, these assessments help members and their care teams understand a benchmark for their own personalized mental health journey. Assessments are completed by members at regular cadences to track changes in mental health. This helps both members and their team understand what’s working when it comes to mental healthcare and what areas are available for growth and improvement.

 Assessments also allow Headspace to make recommendations on a member's care path. For example, members that exhibit high levels of anxiety or depression through the PHQ-9/GAD-7 may receive an in-app recommendation to engage in therapy while members with low levels of stress may be prompted to engage in Headspace content.  

By regularly assessing members engaged in content, coaching, and clinical care, we are better able to track the effectiveness of Headspace’s solutions and understand how we can further improve mental health. To date, Headspace has seen a number of outcomes improvements across our populations, including:

• 59% of Headspace Care members completing follow-up experienced significant improvement in anxiety symptoms
• 69% of Headspace Care members completing follow-up experienced significant improvement in depression symptoms
• 30 days of Headspace improved perceived stress by 43% in employees

At Headspace, these assessments are more than just diagnostic tools; they are catalysts for innovation. By collecting and analyzing data from these evaluations, we can identify patterns and trends that inform product development. This data-driven approach allows us to continuously refine our offerings, ensuring they remain relevant and effective for our users.

Incorporating insights from assessments into our development process enables us to create more personalized and adaptive mental health solutions. As we look to the future, these tools will continue to play a critical role in shaping innovations that enhance user experience and improve mental well-being.

At Headspace, we're committed to leveraging the power of assessments to drive meaningful change in mental healthcare. Learn more about how Headspace helps improve mental health by contacting us here.

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