Approximately one in 25 U.S. adults experiences a serious mental illness (SMI) each year, with many of these individuals relying on antipsychotic medications that can lead to various adverse effects, including medication-induced disorders. One such disorder is tardive dyskinesia (TD), characterized by uncontrollable, repetitive movements of the face, neck, arms, and legs. An issue brief released by Meadows Mental Health Policy Institute (MMHPI) looks closely at the significance of early screening and routine monitoring for medication-induced disorders like TD while emphasizing the critical role of measurement-based care (MBC).

The Role of Measurement-Based Care

Measurement-based care (MBC) is an essential strategy for early screening, intervention, and mitigating medication adverse effects, ultimately improving mental health outcomes. MBC provides a systematic approach to detecting early symptoms and developing and monitoring treatment plans, yet it is practiced by only a fraction of mental health clinicians.

Barriers to the Adoption of Measurement-Based Care

To promote its use, it is essential to understand the barriers and facilitators to adopting MBC treatment in TD and mental health conditions more broadly. Key findings from the MMHPI report indicate four primary categories: Technical Infrastructure, Clinical Operations, Financing, Limited Access to Care, and Limited Awareness.

Policy Recommendations (from MMHPI)

  1. Federal lawmakers should increase funding for IT infrastructure to include behavioral health.
  2. Mental health system leaders should invest in EHRs to optimize data collection and utilization.
  3. Health systems and clinical teams should integrate MBC into clinical workflows.
  4. Health systems should support behavioral health integration and/or coordination between specialty and primary care clinics.
  5. Health systems and clinical teams should utilize evaluation and management time or complexity codes to enable adequate compensation for time spent on MBC.
  6. The U.S. Preventive Services Task Force should declare TD screening and monitoring as a preventive service with a grade A or B recommendation for anyone taking antipsychotic medications. 
  7. Public and private payors should provide adequate reimbursement for MBC and develop value-based care contracts for MBC. 
  8. Federal and state lawmakers should support flexible telehealth policy.
  9. Clinical teams, professional associations and advocacy organizations should educate patients, families and community organizations on TD.
  10. Providers should work to increase patient trust and engagement.

Conclusion

Implementing measurement-based care is an essential tool for improving outcomes for individuals with TD and other mental health conditions. By addressing the identified barriers and adopting the recommended policies, quality of care can be enhanced and help ensure better health outcomes for those affected by SMI.

Read the full report from MMHPI here.