Advertisement

The Healthcare Triple Aim in the Recovery Era

  • Nick KermanEmail author
  • Sean A. Kidd
Point of View

Abstract

Recovery is the guiding vision of mental health systems and policy. However, skepticism has emerged about whether the paradigm can achieve its sought goals. We argue that embedding recovery within a quality improvement framework, such as the Triple Aim, would increase leverage for systems change and advance recovery practice. The Triple Aim’s goals of improving healthcare outcomes, quality, and costs are pertinent to mental health systems, although action is also needed to address the social determinants of health. Accordingly, we propose the recovery-oriented Triple Aim, which could be used to guide policy development and evaluation of mental health services.

Keywords

Recovery Healthcare triple aim Mental health policy Serious mental illness 

Notes

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Research Involving Human Subjects/Animals

This article does not contain any research conducted by the authors involving human participants or animals.

Informed Consent

This article did not involve any participants who required informed consent.

References

  1. Barrett, B., Young, M. S., Teague, G. B., Winarski, J. T., Moore, K. A., & Ochsorn, E. (2010). Recovery orientation of treatment, consumer empowerment, and satisfaction with services: A mediation model. Psychiatric Rehabilitation Journal,34, 153–156.  https://doi.org/10.2975/34.2.2010.153.156.CrossRefPubMedGoogle Scholar
  2. Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The triple aim: Care, health, and cost. Health Affairs,27, 759–769.  https://doi.org/10.1377/hlthaff.27.3.759.CrossRefPubMedGoogle Scholar
  3. Braslow, J. T. (2013). The manufacture of recovery. Annual Review of Clinical Psychology,9, 781–809.  https://doi.org/10.1146/annurev-clinpsy-050212-185642.CrossRefPubMedGoogle Scholar
  4. Bryan, S., & Donaldson, C. (2016). Taking triple aim at the triple aim. Healthcare Papers,15, 25–30.CrossRefGoogle Scholar
  5. Chong, H. Y., Teoh, S. L., Wu, D. B.-C., Kotirum, S., Chiou, C.-F., & Chaiyakunapruk, N. (2016). Global economic burden of schizophrenia: A systematic review. Neuropsychiatric Disease and Treatment,12, 357–373.  https://doi.org/10.2147/ndt.s96649.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Davidson, L., Ridgway, P., Wieland, M., & O’Connell, M. (2009). A capabilities approach to mental health transformation: A conceptual framework for the recovery era. Canadian Journal of Community Mental Health,28, 35–46.  https://doi.org/10.7870/cjcmh-2009-0021.CrossRefGoogle Scholar
  7. Davidson, L., Rowe, M., Tondora, J., O’Connell, M. J., & Lawless, M. S. (2008). A practical guide to recovery-oriented practice: Tools for transforming mental health care. New York: Oxford University Press.Google Scholar
  8. Davidson, L., & White, W. (2007). The concept of recovery as an organizing principle for integrating mental health and addiction services. Journal of Behavioral Health Services and Research,34, 109–120.  https://doi.org/10.1007/s11414-007-9053-7.CrossRefPubMedGoogle Scholar
  9. De Hert, M., Correll, C. U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., et al. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry,10, 52–77.  https://doi.org/10.1002/j.2051-5545.2011.tb00014.x.CrossRefGoogle Scholar
  10. Ellison, M. L., Belanger, L. K., Niles, B. L., Evans, L. C., & Bauer, M. S. (2018). Explication and definition of mental health recovery: A systematic review. Administration and Policy in Mental Health and Mental Health Services Research,45, 91–102.  https://doi.org/10.1007/s10488-016-0767-9.CrossRefPubMedGoogle Scholar
  11. Farmanova, E., Kirvan, C., Verma, J., Mukerji, G., Akunov, N., Phillips, K., et al. (2016). Triple aim in Canada: Developing capacity to lead to better health, care and cost. International Journal for Quality in Health Care,28, 830–837.  https://doi.org/10.1093/intqhc/mzw118.CrossRefPubMedGoogle Scholar
  12. Frederick, T., Tarasoff, L. A., Voronka, J., Costa, L., & Kidd, S. (2017). The problem with “community” in the mental health field. Canadian Journal of Community Mental Health,36, 3–32.  https://doi.org/10.7870/cjcmh-2017-030.CrossRefGoogle Scholar
  13. Government of Ontario. (2019). A healthy Ontario: Building a sustainable health care system, 2nd report from the premier’s council on improving healthcare and ending hallway medicine. Toronto: Queen’s Printer for Ontario.Google Scholar
  14. Green, C. A., Perrin, N. A., Leo, M. C., Janoff, S. L., Yarborough, B. J. H., & Paulson, R. I. (2013). Recovery from serious mental illness: Trajectories, characteristics, and the role of mental health care. Psychiatric Services,64, 1203–1210.  https://doi.org/10.1176/appi.ps.201200545.CrossRefPubMedGoogle Scholar
  15. Hopper, K. (2007). Rethinking social recovery in schizophrenia: What a capabilities approach might offer. Social Science and Medicine,65, 868–879.  https://doi.org/10.1016/j.socscimed.2007.04.012.CrossRefPubMedGoogle Scholar
  16. Insel, T. R. (2008). Assessing the economic costs of serious mental illness. American Journal of Psychiatry,165, 663–665.  https://doi.org/10.1176/appi.ajp.2008.08030366.CrossRefPubMedGoogle Scholar
  17. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: The National Academies Press.  https://doi.org/10.17226/10027.CrossRefGoogle Scholar
  18. Katsakou, C., Bowers, L., Amos, T., Morriss, R., Rose, D., Wykes, T., et al. (2010). Coercion and treatment satisfaction among involuntary patients. Psychiatric Services,61, 286–292.  https://doi.org/10.1176/ps.2010.61.3.286.CrossRefPubMedGoogle Scholar
  19. Kidd, S. A., McKenzie, K. J., & Virdee, G. (2014). Mental health reform at a systems level: Widening the lens on recovery-oriented care. Canadian Journal of Psychiatry,59, 243–249.  https://doi.org/10.1177/070674371405900503.CrossRefPubMedGoogle Scholar
  20. Kurdyak, P., Wiesenfeld, L., & Sockalingam, S. (2016). Choosing wisely? Let’s start with working wisely. Canadian Journal of Psychiatry,61, 25–28.  https://doi.org/10.1177/0706743715621259.CrossRefPubMedGoogle Scholar
  21. Laderman, M. (2015). Behavioral health integration: A key component of the triple aim. Population Health Management,18, 320–322.  https://doi.org/10.1089/pop.2015.0028.CrossRefPubMedGoogle Scholar
  22. Lora, A., Conti, V., Leoni, O., & Rivolta, A. L. (2011). Adequacy of treatment for patients with schizophrenia spectrum disorders and affective disorders in Lombardy, Italy. Psychiatric Services,62, 1079–1084.  https://doi.org/10.1176/appi.ps.62.9.1079.CrossRefPubMedGoogle Scholar
  23. Mery, G., Majumder, S., Brown, A., & Dobrow, M. J. (2017). What do we mean when we talk about the triple aim? A systematic review of evolving definition and adaptations of the framework at the health system level. Health Policy,121, 629–636.  https://doi.org/10.1016/j.healthpol.2017.03.014.CrossRefPubMedGoogle Scholar
  24. Mitchell, A. J., Malone, D., & Doebbeling, C. C. (2009). Quality of medical care for people with and without comorbid mental illness and substance misuse: Systematic review of comparative studies. British Journal of Psychiatry,194, 491–499.  https://doi.org/10.1192/bjp.bp.107.045732.CrossRefPubMedGoogle Scholar
  25. National Health Service. (2014). NHS five year forward view. Retrieved June 14, 2019 from https://www.england.nhs.uk/publication/nhs-five-year-forward-view/.
  26. National Health Service. (2017). Next steps on the NHS five year forward view. Retrieved June 14, 2019 from https://www.england.nhs.uk/publication/next-steps-on-the-nhs-five-year-forward-view/.
  27. New Zealand Minister of Health. (2016). New Zealand health strategy: Future directions. Wellington, New Zealand: Author.Google Scholar
  28. Newman, D., O’Reilly, P., Lee, S. H., & Kennedy, C. (2015). Mental health service users’ experiences of mental health care: An integrative literature review. Journal of Psychiatric and Mental Health Nursing,22, 171–182.  https://doi.org/10.1111/jpm.12202.CrossRefPubMedGoogle Scholar
  29. Obucina, M., Harris, N., Fitzgerald, J. A., Chai, A., Radford, K., Ross, A., et al. (2018). The application of triple aim framework in the context of primary healthcare: A systematic literature review. Health Policy,122, 900–907.  https://doi.org/10.1016/j.healthpol.2018.06.006.CrossRefPubMedGoogle Scholar
  30. Pincus, H. A., Spaeth-Rublee, B., Sara, G., Goldner, E. M., Prince, P. N., Ramanuj, P., et al. (2016). A review of mental health recovery programs in selected industrialized countries. International Journal of Mental Health Systems,10, 73.  https://doi.org/10.1186/s13033-016-0104-4.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., et al. (2014). Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems. World Psychiatry,13, 12–20.  https://doi.org/10.1002/wps.20084.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Tepper, M. C., Cohen, A. M., Progovac, A. M., Ault-Brutus, A., Leff, H. S., Mullin, B., et al. (2017). Mind the gap: Developing an integrated behavioral health home to address health disparities in serious mental illness. Psychiatric Services,68, 1217–1224.  https://doi.org/10.1176/appi.ps.201700063.CrossRefPubMedGoogle Scholar
  33. van Weeghel, J., van Zelst, C., Boertien, D., & Hasson-Ohayon, I. (2019). Conceptualizations, assessments, and implications of personal recovery in mental illness: A scoping review of systematic reviews and meta-analyses. Psychiatric Rehabilitation Journal,42, 169–181.  https://doi.org/10.1037/prj0000356.CrossRefPubMedGoogle Scholar
  34. Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the true global burden of mental illness. Lancet Psychiatry,3, 171–178.  https://doi.org/10.1016/s2215-0366(15)00505-2.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis. JAMA Psychiatry,72, 334–341.  https://doi.org/10.1001/jamapsychiatry.2014.2502.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Wang, P. S., Demler, O., & Kessler, R. C. (2002). Adequacy of treatment for serious mental illness in the United States. American Journal of Public Health,92, 92–98.  https://doi.org/10.2105/ajph.92.1.92.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Whittington, J. W., Nolan, K., Lewis, N., & Torres, T. (2015). Pursuing the triple aim: The first 7 years. Milbank Quarterly,93, 263–300.  https://doi.org/10.1111/1468-0009.12122.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of PsychologyUniversity of OttawaOttawaCanada
  2. 2.Department of PsychiatryUniversity of TorontoTorontoCanada

Personalised recommendations