If you can’t measure it, you can’t manage it: the case for outcome tracking in mental health coaching

If you can’t measure it, you can’t manage it: the case for outcome tracking in mental health coaching.

Self-efficacy, a person’s confidence in their own ability to manage their mental health, is one of the strongest predictors of long-term recovery. It is also one of the hardest things to build if a program cannot tell whether it is building it. Most mental health coaching programs measure completion. Very few measure whether the people who completed the program left with more confidence in managing their mental health than when they arrived.

What measurement looks like when it is done well

The headspace network measures outcomes across all 108 centres. The published results from 58,233 participants (PLOS ONE, 2023) show 70% significantly improved on at least one outcome domain. They also show 31% significantly deteriorated on at least one. Both figures are in the published data. That combination is what clinical honesty looks like: you can see who the program is helping, who it is not, and where it needs to change.

The infrastructure for systematic outcome tracking already exists in Australia. The Australian Commission on Safety and Quality in Health Care maintains condition-specific validated Patient Reported Outcome Measures (PROMs) for mental health. These are standardised tools that capture changes in a person’s symptoms, functioning, and confidence in managing their own health over the course of a program. Alongside PROMs sit Patient Reported Experience Measures (PREMs), tools that capture how a person experienced the care itself: whether they felt heard, whether the support was accessible, whether they would engage again. PROMs tell you whether the program worked. PREMs tell you why. The tools are not the barrier.

The finding insurers should not overlook

The 2022 evaluation of Australia’s Better Access initiative found that 10 to 20% of episodes involved clinical deterioration. For a program receiving billions in Medicare funding, that is a finding worth sitting with. It only became visible because someone measured outcomes systematically and reported them in full.

A coaching program that does not measure outcomes does not produce better outcomes than one that does. It produces outcomes it cannot see.

For insurers, the relevant question is not whether a provider collects PROMs and PREMs. It is whether they publish the deterioration data alongside the improvement data and whether the program design changes in response.

Measurement is not reassurance. It is the mechanism by which a coaching program stays clinically honest.

See how Spectrum.Life’s Mental Health Coaching Program measures and reports outcomes across every participant.