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Improving quality of life assessments for high-need adult Medicaid service users with mental health conditions

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Abstract

Purpose

There is a lack of consensus on how to evaluate health and social service programs for people with mental health (MH) conditions. Having service users be the primary decision makers in selecting outcome measures can inform a meaningful evaluation strategy. We sought to identify the quality of life (QoL) survey preferences of high-need adult service users with MH conditions.

Methods

A systematic review identified generic, self-reported QoL surveys with evidence of validity in MH populations of interest. An advisory panel selected the most promising surveys to assess the success of programs like Medicaid for MH service users. Three groups of high-need, adult service users with MH conditions and one group of direct care staff ranked the surveys from the advisory panel, and generated and ranked characteristics that were desirable or undesirable in a QoL survey.

Results

Twenty-two surveys met the inclusion criteria. Of the six surveys selected by the advisory panel, groups of service users and direct care staff most preferred the Warwick-Edinburg Mental Well-being Scale (WEMWBS). The WEMWBS best embodied the features prioritized by the groups: to have a user-friendly format and positive focus, to be clearly worded and brief, and to avoid presumptive or unrealistic items. Service user groups appreciated survey topics most amenable to self-report, such as satisfaction with relationships.

Conclusion

Using QoL surveys that service users prefer can reduce the chance that deteriorating QoL is going unchecked, and increase the chance that decisions based on survey findings are meaningful to service users.

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Data availability

Data available upon request.

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Acknowledgements

The authors thank the individuals who participated in this project for sharing their insights into quality of life measurement in the mental health field. We also thank the providers who assisted in the recruitment of participants. The first author also thanks Mathematica Policy Research for providing fellowship support to pursue this important research on outcomes for Medicaid beneficiaries with complex needs.

Funding

The research reported herein was performed pursuant to a grant from the U.S. Social Security Administration (SSA) funded as part of the Disability Research Consortium. The opinions and conclusions expressed are solely those of the author(s) and do not represent the opinions or policy of SSA or any agency of the Federal Government. Neither the United States Government nor any agency thereof, nor any of their employees, makes any warranty, expressed or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of the contents of this report. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply endorsement, recommendation or favoring by the United States Government or any agency thereof.

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Authors and Affiliations

  1. Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA

    Adrienne Nevola, Holly C. Felix & J. Mick Tilford

  2. Department of Health Policy, Economics, and Management, University of Texas Health Science Center, 11937 U.S. Highway 271, Tyler, TX, 75708, USA

    Michael E. Morris

  3. Psychiatric Research Institute, Division of Health Services Research, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA

    Teresa Hudson

  4. Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA

    Nalin Payakachat

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  1. Adrienne Nevola
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  2. Michael E. Morris
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  3. Holly C. Felix
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Correspondence to Adrienne Nevola.

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None of the authors have any financial relationship relevant to the study, or any other conflict of interest associated with the study.

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The University of Arkansas for Medical Sciences (UAMS) Institutional Review Board approved the study as not human subjects research.

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Nevola, A., Morris, M.E., Felix, H.C. et al. Improving quality of life assessments for high-need adult Medicaid service users with mental health conditions. Qual Life Res 30, 1155–1164 (2021). https://doi.org/10.1007/s11136-020-02694-0

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