Implementation of a psychological treatment outcomes evaluation system for young people at Uruguay's National Health System: Using CORE‐OM

Abstract

Routine outcome measurement is an important practice to improve the quality of mental health services. Since 2011, it has been mandatory for health services to offer psychotherapy in Uruguay's National Health System. Adolescents and young people are a priority population. The lack of information about the functioning and the effectiveness of the mental health services focused on youth is an obstacle to assess and, as a consequence, to improve the services. The objective of this study was to evaluate the implementation of a system to establish the characteristics and outcomes of psychological treatment received by young people at services provided by Uruguay's National Health System. The present study was the first of its kind to examine the outcomes of psychotherapy offered in mental health services. A pre-post design in a naturalistic setting was used. Sixty-nine participants, aged 16 to 24 years, and 26 therapists from four health services participated. Sociodemographic and clinical questionnaires, the Clinical Outcome Routine Evaluation-Outcome Measure (CORE-OM; Evans et al., 2002) and a semi-structured interview were applied to assess the perception of change. CORE-OM results portrayed a decrease in psychological distress. Interview data helped to better understand the perception of change. A high number of dropouts revealed the need for the services to use strategies to prevent early dropouts in young users. The CORE-OM appears to be a valuable tool. Barriers for outcomes system implementations are discussed and may prove useful to other countries where there is a lack of an outcome-oriented clinical culture.