Treatment plans: A collaborative approach to mental healthcare

When we think about many of the tools used by healthcare providers today — such as clinical and progress notes — many of them are a one-way analysis. Often times, patients never (or barely) get to view notes, verify information, or provide consensus on the information provided to ensure that it is in line with their goals. However, a treatment plan is another tool often used to treat behavioral health issues, and one that shines because it drives true collaboration between a patient and their mental health provider.

Many patients have likely been to their primary care doctor with a specific ailment and left the office with a verbal list of goals and objectives to achieve for the next visit that was delivered by our doctor? Who can fully remember what was said? That is why treatment plans are pivotal to driving positive change in healthcare, particularly when used with mental and behavioral health patients.

Together, alongside their provider(s), patients can be a part of creating the goals, objectives, interventions, and outcomes they are looking for. In this case, patients have a sense of immediate “buy-in” to their treatment and are more likely to partake in the required steps — since they were a part of building those steps. Treatment plans allow for the adherence to a more successful clinical outcome. 

These plans typically highlight important assessment information, define areas of concern, and establish concrete goals for treatment. They are classically used by psychiatrists, psychologists, professional counselors, therapists, nursing teams, and social workers in most levels of care. 

Here are some important elements that make up solid and actionable treatment plans.

1. Patient demographic info: Basic demographic information, psychosocial history, onset of symptoms and family histories.

2. Provider diagnosis: May be one or multiple diagnoses and may also include past diagnoses.

3. Treatment goals: The building blocks of a treatment plan; they are unique and tailored specifically to the patient seeking treatment. Oftentimes they include a metric of some sort, like a percentage or rating scale that helps tie into how patient progress will be tracked.

4. Measurable objectives: The small, achievable steps that outline how the patient will get to the larger goals.

5. Interventions: Techniques the provider will implement to assist the patient in gaining goal achievements (i.e. medications, talk therapy, breathing exercises, etc.)

6. Timelines to treatment: Target dates to completing each goal is included to help the patient adhere to the program and the provider to continually provide updates to the plan.

7. Frequency: How often the patient needs to engage with the provider for optimal success.

8. Signatures: Provides a 2-way street for plan adherence from both the provider and the patient. Capturing signatures not only solidifies the collaboration between provider and patient but provides evidence of insurance reimbursement requirements.

9. Patient progress tracking: Providers have a way to capture and update a patient's progress each step of the way.

It’s important to note that these plans typically aren’t developed until after a provider has met with a patient at least once and are usually outlined during the 2nd or 3rd patient visit. A patient will first undergo an initial evaluation to understand why they are seeking treatment. During this visit or subsequent visit, a provider may conduct a deeper evaluation to gather the entire medical history of the patient. They also may perform a mini-mental-status exam (MMSE), which involves observation — looking at the patient’s overall physical appearance in addition to how they interact with the provider and/or those around them. 

From there, a provider can make an initial diagnosis(es) that can then be shared with the patient. Then the collaboration can begin with outlining potential goals and objectives for treatment.

Being a part of developing a customized treatment allows patients to have a voice in the goals and objectives that outline each step of their program. Oftentimes, simply being a part of a process makes people more likely to adhere to objectives that satisfy a goal (like working alongside a motivating personal trainer rather than copying a diet program from a manual) and are more likely to stay on track. That’s a win-win for the practice and the patient. 

Additionally, practices are more likely to see reimbursement from insurance providers in some cases, as treatment plans show proof that treatment was provided and that both parties participated in the process via signatures.

According to the National Alliance on Mental Health, untreated mental illness costs the United States approximately $300 billion in loss of productivity. Without treatment, the consequences are staggering for both individuals and our society. Driving this astounding cost is the domino effect that stems from lack of or improper treatment, which includes things like unnecessary disability, unemployment, inappropriate incarceration, and more. Early identification and treatment are of vital importance; by getting patients the treatment they need as early as possible, recovery is accelerated and the brain is protected from further harm related to the course of illness.

As we continue to break the stigma surrounding mental health, hear from advocates, and make care more accessible through insurance, items like treatment plans become critical to driving down overall costs and ensure that both individuals and our society can continue to function in harmony.