Observations from the national implementation of Measurement Based Care in Mental Health in the Department of Veterans Affairs.

In 2016, the Department of Veterans Affairs (VA) began the Measurement-Based Care in Mental Health Initiative to implement measurement-based care (MBC) across all mental health programs with the goal of making MBC the national standard of care. Phase 1 of this initiative, beginning in fall 2016 through fall 2017, was carefully designed to meet the ambitious goals of the organization while minimizing implementation barriers. Phase 1 participants reported an increase in MBC implementation across mental health programs with a simultaneous increase in the proportion of patient-reported outcome measures among veterans new to mental health care. The initiative adopted a broad range of strategies informed by implementation science to facilitate implementation at the organizational, provider, and patient level which are described here. The initiative was successful, but use of patient-reported outcome measures across VA mental health remains proportionally low. Technology, VA's hierarchical structure, and competition from other VA mental health initiatives may have slowed national implementation efforts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).