The Opportunity

In the United States, it is estimated that approximately 26.4 percent of the population suffers from a diagnosable mental disorder. These disorders – which can include serious mental illnesses, substance use disorders, and depression – are associated with poor health outcomes, increased costs, and premature death. Although general behavioral health disorders are widespread, the burden of serious mental illness is concentrated in about six percent of the population. In addition, many people suffer from more than one mental disorder at any given time; nearly half of those suffering from one mental illness meet the criteria for at least two more. By 2020, behavioral health disorders are expected to surpass all physical diseases as the leading cause of disability worldwide.

In 2005, an estimated $113 billion was spent on mental health treatment in the United States. $22 billion of that amount was spent on substance use treatment alone, making substance use one of the most costly (and treatable) illnesses in the nation. Financial estimates for behavioral health disorders inflate substantially when wider social costs are factored in such as criminal, welfare, juvenile, and future earnings potential.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is currently advancing the National Framework for Quality Improvement in Behavioral Health Care (NBHQF). In the framework, SAMHSA notes that efforts to successfully implement the portions of the Affordable Care Act (ACA) relevant to Behavioral Health will require a better understanding of the current status and needs of the behavioral health population and delivery system, as well as an increased ability to adequately assess and monitor these populations over time. Of course, meaningful mental health performance measurement is a key driver to transform the healthcare system and advance both of these goals.

In 2012, NQF endorsed 10 behavioral health measures in the areas of tobacco and alcohol use, medication adherence, diabetes health screening and assessment, and hospitalization follow-up. A subsequent phase of work recommended 20 measures for endorsement in the areas of: tobacco and alcohol use, depression screening, medication adherence, and hospital-based inpatient psychiatric services. These recommendations were put forth for public comment in September, 2013; the project will be completed by March of 2014.

NQF Process

Measures will be considered for NQF endorsement as national voluntary consensus standards. Consensus on the recommendations developed through NQF’s formal Consensus Development Process (CDP, Version 1.9). This project involves the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a Standing Committee.

Related NQF Project

Behavioral Health Phases I and II

Funding

This project is supported under a contract provided by the Department of Health and Human Services.

For information about the availability of auxiliary aids and services for NQF’s federally funded projects, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.

Contact Information

For more information, please contact Poonam Bal at 202-783-1300 or via email at behavioralhealth@qualityforum.org.