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The Feasibility of Computerized Patient Self-assessment at Mental Health Clinics

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Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

Objectives

Improving the quality of care for severe mental illness (SMI) has been difficult because patients’ clinical information is not readily available. Audio computer-assisted self-interviewing (ACASI) supports data collection by asking patients waiting for appointments clinical questions visually and aurally. It has improved outcomes for many disorders. While reliable and accurate for SMI in research settings, this study assesses questions about ACASI’s feasibility in usual care.

Design

Patient and provider surveys and provider focus groups after 12 months of ACASI implementation.

Setting

Two outpatient mental health clinics in Los Angeles, one run by the Department of Veterans Affairs and the other by Los Angeles County Department of Mental Health.

Participants

266 patients with SMI and 14 psychiatrists.

Intervention

Patients completed an ACASI survey on symptoms, drug use, medication adherence and side-effects by internet using a touch-screen monitor. A 1-page report summarizing each patient’s results was printed and given to providers by patients during appointments.

Main Outcome Measure

Feedback surveys (patients and psychiatrists) and focus groups and interviews (psychiatrists) assessed usability, usefulness, effects on treatment, and barriers to sustaining ACASI.

Results

Patients believed the PAS was enjoyable, easy to learn and use, and that it improved communication with their psychiatrists. Providers believed the PAS was easy to use, had a small impact on care, could be improved by being more detailed and comprehensive, and requires outside support to continue its use.

Conclusions

ACASI was easy to use and enhanced communication. Systems like this can be a valuable part of quality improvement projects.

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Notes

  1. All patient responses were on the following scale: 1 = strongly disagree, 5 = neither agree nor disagree, 9 = strongly agree

  2. 1 = very easy, 2 = easy, 3 = kind of difficult, 4 = difficult, 5 = very difficult

  3. 1=not useful, 5=somewhat useful, 9=very useful

  4. 1 = strongly disagree, 5 = neither agree nor disagree, 9 = strongly agree

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Acknowledgements

Work on this paper was supported by The Department of Veterans Affairs (VA) Health Services Research & Development service (MNH 04-389 and MHS 03-218-1), by the NIMH UCLA-RAND Center for Research on Quality in Managed Care (MH 068639), and by the VA Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC). The authors would like to thank Jennifer Pope, Jeff Zito, Steve Castellon, Stryder Lewis, Sue Eisen, and Carol Eisen for their contributions to the project. Any opinions expressed are the authors’, and do not necessarily represent the views of the Department of Veterans Affairs and the Los Angeles County Department of Mental Health.

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Authors and Affiliations

  1. VA Desert Pacific Mental Illness Research, Education, & Clinical Center, 11301 Wilshire Blvd. MIRECC 210A, Los Angeles, CA, 90073, USA

    Matthew Chinman, Joseph Hassell & Alexander S. Young

  2. The Leavey Center for the Study of Los Angeles, Loyola Marymount University, Los Angeles, CA, USA

    Jennifer Magnabosco

  3. Los Angeles County Department of Mental Health, 11080 W. Olympic Blvd., West Los Angeles, CA, 90064, USA

    Nancy Nowlin-Finch

  4. UCLA Semel Institute of Neuroscience & Human Behavior, 300 UCLA Medical Plaza, Suite 1544, Los Angeles, CA, 90095-7057, USA

    Susan Marusak

  5. UCLA Department of Psychiatry, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA, 90024, USA

    Alexander S. Young

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  1. Matthew Chinman
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  2. Joseph Hassell
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  3. Jennifer Magnabosco
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  4. Nancy Nowlin-Finch
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  6. Alexander S. Young
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Correspondence to Matthew Chinman.

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Chinman, M., Hassell, J., Magnabosco, J. et al. The Feasibility of Computerized Patient Self-assessment at Mental Health Clinics. Adm Policy Ment Health 34, 401–409 (2007). https://doi.org/10.1007/s10488-007-0120-4

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  • DOI: https://doi.org/10.1007/s10488-007-0120-4

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