Value-Based Mental Health Services for Youth and Families: The Role of Patient-Reported Outcome Measures in Youth Mental Health Services
Bibliographic record
Abstract
In Alberta, the responsibility for youth mental-health is shared among three separate government ministries, compounding the challenge of determining the value of services delivered, especially from the youth’s own perspective. As a result, Alberta’s ability to measure service quality at the systems level is limited. Yet, given the short-term and long-term effects of poor mental health on youth, families, and society, there are clinical, moral, and economic imperatives for ensuring that all services provided are of the highest value possible. Currently, Alberta is limited to estimating value mainly through quantitative measures focused on the cost of service delivery. However, value-based health-care services are measured as quality or outcomes for persons receiving health services in relation to the costs of delivering those services. One approach is to measure outcomes of youth receiving mental-health services from their own perspective to achieve value-based measurement of youth mental-health services. Patient-reported outcome measures (PROMs) are questionnaires filled out by the persons receiving mental-health services themselves, and assess their self-reported health and well-being. PROMs have been shown to be important in evaluating the value of health-care services both at the individual and systems level. At the individual level, PROMs allow patients and health-care providers to track progress over time. At the systems level, PROMs data can be compiled to evaluate trends between different sites or different health-care services or treatments over time, to help improve quality. Policy-makers can use these comparisons to help pinpoint which services offer the most value. Given resource constraints, implementing PROMs province-wide in Alberta can improve the value of youth mental-health services at a time when they have become a matter of great urgency. Improving the quality and outcomes for youth and their families in the short term will deliver positive socioeconomic impacts in the future.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.154 | 0.205 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.008 | 0.016 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.009 | 0.006 |
| Open science | 0.004 | 0.006 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".