Creating An Environment of Quality
Through Evidence-Based Practices

The New York State Office of Mental Health (OMH) has embraced the 'winds of change' sweeping the nation-a renewed focus on quality, based on evidence-based treatments and practices as the foundation of structural and clinical work. OMH has pledged to promote and enact positive changes for the current system of care to reflect a continued commitment to ensuring the highest quality and most effective mental health services possible. Consistent with the foundation of the OMH Strategic Statement, the Evidence-Based Practices initiative seeks to improve the ABCs of mental health care, which include accountability for results, best practices, and coordination of services and programs throughout the mental health system in New York State. The OMH Progress Report series documents the results of our efforts to promote the ABCs of mental health care and implementation of Evidence-Based Practices.

The National Message to Improve Quality

In 1999, The Surgeon General Report included the following statements regarding mental healthcare in the United States:

• "The efficacy of mental health treatments is well documented…";
• "A range of treatments exists for most mental disorders";
• "Critical gaps exist between those who need service and those who receive service… between optimally effective treatment and what many individuals receive in actual practice settings".

In 2001, the Institute of Medicine released a provocative report titled: Crossing the Quality Chasm: A New Health System for the 21st Century that challenges all healthcare providers to shift towards a major rethinking of national and international healthcare improvements.

New York State's Response

Following the footsteps of national leaders and experts, the New York State Office of Mental Health held the Best Practices conference in New York City in June 2001 to kickoff the Winds of Change campaign. Evidence-Based Practices for adults and children were identified. Since the Best Practices conference, OMH has been building awareness of these practices, assisting in implementation efforts, and has been moving the mental health system towards a system focusing on continuous quality improvement. OMH has also identified the foundation of effective and efficient Evidence-Based Practices as including both quality practices and Evidence-Based Practices values.

• Quality Practices Underlying Evidence-Based Practices
  • The nature and quality of the therapeutic relationship is critical.
  • Quality practices are inclusive and continuous.
  • Quality practices are individualized: matching services to the needs, strengths, preferences, and values of the recipient.
  • Quality practices promote responsible partnerships via informed and shared decision making.
  • Quality practices can't be separated from quality practitioners.
  • Quality practices are dynamic.
  • Quality practices are outcome oriented and continuous.
  • Quality practices are culturally competent.
• The Evidence-Based Practices Values
  • Recovery
    As a unifying concept: creating and supporting services, practices and policies that facilitate safety, hope, choice, and empowerment.
  • Partnerships Building
    Meaningful and sustained quality is maximized through multi-stakeholder involvement.
  • Optimal Treatment
    Every single individual is entitled to receive mental health services that are evidence-based and effective. Avoid the underuse, overuse, or misuse of services.
  • High Need
    Focus on the needs of the most seriously disabled and vulnerable population.

OMH has focused on initiatives to advance the EBPs and quality care agenda. This ongoing work is designed to build a foundation that supports routine use of science to quality practice. Particularly in the aftermath of September 11^th, the NYSOMH launched a quality improvement campaign to both promote effective mental health practices, supported by research, and build individual and community resiliency. This commitment has been exemplified in Project Liberty, a program that provides free crisis counseling services to persons, families and groups most affected by the September 11^th World Trade Center disaster. Other major NYSOMH initiatives, such as performance-based contracting, and Assertive Community Treatment (ACT) are further examples of how NYSOMH is committed to implementing evidence-based practices and quality mental health care across New York State.

What Are Evidence-Based Practices?

OMH is dedicated to providing mental health services that are based on the best evidence available and improve outcomes and quality of life for people diagnosed with a mental illness. Over the past decade, research in the field of mental health has demonstrated that there is consistent scientific evidence that some specific practices work well in improving outcomes in the lives of individuals diagnosed with a severe mental illness. These specific practices, grounded in consistent research findings, are called Evidence-Based Practices (EBPs). EBPs are interventions for which there is consistent, scientific evidence showing that they improve consumer outcomes. National studies have shown that a majority of individuals diagnosed with a severe mental illness do not have access to these EBPs.

Background Artwork