Evidence-based psychosocial interventions not being used in current practice

There is a significant disparity between psychosocial interventions proven to be effective and those that are commonly delivered, according to a report from the National Academies of Sciences, Engineering and Medicine.

“A wide variety of psychosocial interventions play a major role in the treatment of mental health and substance use disorders, but most consumers of mental health care find it difficult to know whether they are receiving high-quality care,” study researcher Mary Jane England, MD, of Boston University, said in a press release. “The efficacy of a broad range of psychosocial interventions has been established through hundreds of randomized controlled clinical trials and numerous meta-analyses. However, for many patients, the quality of care that is actually delivered is less than ideal.”

Mary Jane England

The National Academies of Sciences, Engineering and Medicine formed a committee of researchers to assess and improve the implementation of evidence-based psychosocial interventions across clinical practice.

The committee found that psychosocial interventions shown to be effective in research settings were not used routinely in clinical practice, potentially due to poor access, insurance coverage and fragmentation of care, according to the release.

To promote the use of evidence-based psychosocial interventions, the committee established a framework that calls for strengthening the evidence base for interventions, identifying elements of effective interventions, conducting systematic reviews to inform clinical guidelines, developing quality measure to track intervention outcomes and efficacy and implementing quality.

The committee feels psychosocial interventions should be viewed similar to physical health care and greater emphasis should be placed on context and infrastructure for high-quality interventions.

They advocate that the U.S. Department of Health and Human Services adopt their framework to support policy, research and implementation strategies designed to improve implementation of psychosocial interventions.

“There is a need to improve the outcomes of psychosocial interventions, given that about one in five people in the U.S. suffers from mental health and substance use disorders,” Victor J. Dzau, MD, president of the National Academy of Medicine (formerly the Institute of Medicine), said in the release. “Our committee’s report provides an important framework to help fully realize the consistent use of high-quality, evidence-based psychosocial interventions in everyday care.” – by Amanda Oldt

Disclosure: The study was sponsored by the American Psychiatric Association, American Psychological Association, Association for Behavioral Health and Wellness, National Association of Social Workers, National Institutes of Health, Substance Abuse and Mental Health Services Administration, Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services, and U.S. Department of Veterans Affairs. Please see the full study for a list of all other authors’ relevant financial disclosures.

Reference:

England MJ, et al. Psychosocial interventions for mental and substance use disorders: a framework for establishing evidence-based standards. Washington, DC: The National Academies Press, 2015.