A Psychiatric Services Provider Rating System

PsychOdyssey Concept Note, August 31, 2011. ©PsychOdyssey Services, Inc., 2011. For a pdf copy of this Concept Note, click here.

Concept	An online psychiatric service provider rating system of, by, and for individuals with psychiatric disabilities and their families.
Description	A web-based information, review, and rating system of providers of psychiatric, therapeutic, counseling, and social services to individuals with severe mental illnesses, with special attention to the detailed information needs and distinct lived experiences of such individuals and to evidence-based and promising practices in applicable fields.
Rationale	Individuals with serious mental illness are significant consumers of psychiatric services from a variety of individuals, institutions, and agencies. These include: psychiatrists, psychologists, nurses, employment counselors, social workers, addictions counselors, government bureaucrats, and more. Particularly at the higher end of the psychiatric services hierarchy, there can be significant differences in training and treatment philosophy. Because providers can bring to bear so many different—and potent— influences to an individual’s recovery, service consumers will achieve better recoveries by knowing more about their providers and hearing how other consumers rate and rank them.Despite the rise of web-based information and review delivery systems like Angie’s List and HealthGrades, there remains very little detailed consumer review information about providers, for at least three reasons: Not enough providers are listed with such services. Not enough consumers comment on such lists about their provider experiences. Prompted often by overly simplistic questionnaires, comments are generally too general to be of use to other consumers. What special information do consumers need to know? For instance, when choosing psychiatrists, not only are generic considerations like “bedside manner” important. Responses to very specific questions should be considered (and rated). For instance, does the psychiatrist… Prescribe antipsychotics heavily during initial onsets? Prescribe many medications at once? Follow the “medical model” or the “recovery model”? Know the conclusions of the CATIE studies? Engage in talk therapy? Accept Medicaid? Ever refuse a patient’s medications request? Invite family members into sessions? Return phone calls within 24 hours? Carefully follow the risks of metabolic syndrome? Know at least five residential treatment centers? Work with those having dual disorders (like addictions)? Know at least five psychotherapists to recommend? Know about the long-term effects of antipsychotics? Explain the risks of antidepressants? Demonstrate clinical pessimism? Apply the New Freedom Commission’s principles? A psychiatric services provider rating system would increase the effectiveness of individuals and their family members in determining and directing their own recoveries. Provider accountability to consumers and their families would improve. Consumers and their families would be more empowered.
Suppliers	Ideally, an organization already serving consumers and families, with a wide client outreach and significant collective lived experience of individuals.
Users	Consumers of psychiatric services Family members
Potential Partners	Service providers Hospitals Government agencies Advocacy groups Professional associations Other review services (e.g., Angie’s List)
Operations Model	To be developed.
Economics	Revenue: Corporate sponsorship Advertising Subsidy from a comprehensive service entity offering such a service as part of package (e.g.., a credit union for consumers?) Expenses: Research Computer equipment Web design Web hosting service Staff: 1 operations , 1 marketing, 1 research, volunteers Rent (in kind?)
Possible Development Funding Sources	Foundation grants SAMHSA
Features	Well-formatted website with simple, yet sufficiently detailed surveys. Areas for comments and rankings.
Benefits	Comparability among service providers Improved understanding of services system Efficiency in provider sourcing Increased effectiveness of referrals by intensive case managers Empowerment of individuals and family members
Comparables	Angie’s List (www.angieslist.com)HealthGrades (www.healthgrades.com)
Considerations for Further Research	How to maintain independence and avoid undue influence upon reviews and ratings? How to ensure objective data collection? What would be the impact on this idea of current payment system for services? Would the idea even more applicable with a voucher system of services funding for consumers? How many occasions per time period would consumers use such a service?
For Further Information	PsychOdyssey Services, Inc., 20 Nassau Street, Suite 232, Princeton, NJ 08542, t: 609-658-2008, e: info@psychodssey.net