The case against routine outcome monitoring

Abstract

ABSTRACT Objective The practice of routine outcome monitoring (ROM) – that is, monitoring clinical outcomes using standardized measures at regular intervals – is becoming increasingly ubiquitous for everyday practitioners in mental healthcare. ROM is recommended, if not mandated, by a growing number of professional and governmental bodies internationally, and there are mounting pressures to incorporate ROM practices into mental health services. Method This article presents a critical review of the published literature suggestive that the feasibility, utility, and most importantly, efficacy, of ROM is less effusive than is generally portrayed by advocates of the practice, particularly in naturalistic settings. Results The 2022 Better Access Evaluation Report is examined as an archetypal case study whereby research findings are grossly misrepresented in order to reach recommendations supportive of implementing ROM into healthcare systems. Reviewed research suggests that both clients and clinicians experience ROM as cumbersome, and real-world efforts to incorporate ROM into public health services have fostered serious ethical violations. Conclusions The social, political, and economic forces responsible for the galvanizing ROM movement are examined.