Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada; Research Department for Clinical, Educational and Health Psychology, University College London, London, UK.
London, UK.
Lancet Psychiatry. 2021 Dec;8(12):1094-1102. doi: 10.1016/S2215-0366(21)00122-X. Epub 2021 Oct 14.
Mental health research grapples with research waste and stunted field progression caused by inconsistent outcome measurement across studies and clinical settings, which means there is no common language for considering findings. Although recognising that no gold standard measures exist and that all existing measures are flawed in one way or another, anxiety and depression research is spearheading a common metrics movement to harmonise measurement, with several initiatives over the past 5 years recommending the consistent use of specific scales to allow read-across of measurements between studies. For this approach to flourish, however, common metrics must be acceptable and adaptable to a range of contexts and populations, and global access should be as easy and affordable as possible, including in low-income countries. Within a measurement landscape dominated by fixed proprietary measures and with competing views of what should be measured, achieving this goal poses a range of challenges. In this Personal View, we consider tensions between affordability, sustainability, consistency, and adaptability that, if not addressed, risk undermining the common metrics agenda. We outline a three-pronged way forward that involves funders taking more direct responsibility for measure development and dissemination; a move towards managing measure dissemination and adaptation via open-access measure hubs; and transitioning from fixed questionnaires to item banks. We argue that now is the time to start thinking of mental health metrics as 21st century tools to be co-owned and co-created by the mental health community, with support from dedicated infrastructure, coordinating bodies, and funders.
心理健康研究面临着研究浪费和领域进展缓慢的问题，这是由于研究和临床环境中不一致的结果测量造成的，这意味着没有共同的语言来考虑研究结果。尽管认识到没有黄金标准的测量方法，而且所有现有的测量方法都在某种程度上存在缺陷，但焦虑和抑郁研究正在引领一种共同的度量标准运动，以协调测量，过去 5 年中有多项举措建议一致使用特定的量表，以便在研究之间进行测量的相互参照。然而，为了使这种方法蓬勃发展，共同的度量标准必须是可接受的，并能适应各种情况和人群，而且全球的获取应该尽可能简单和负担得起，包括在低收入国家。在以固定的专有措施为主导的测量环境中，以及对于应该测量什么存在不同的观点，要实现这一目标面临着一系列挑战。在这篇个人观点中，我们考虑了可负担性、可持续性、一致性和适应性之间的紧张关系，如果这些问题得不到解决，可能会破坏共同度量标准的议程。我们概述了一个三管齐下的前进道路，包括让资助者更多地直接负责措施的开发和传播；朝着通过开放获取的措施中心来管理措施的传播和适应的方向发展；以及从固定问卷转向项目库。我们认为，现在是时候将心理健康指标视为 21 世纪的工具，由心理健康社区共同拥有和共同创造，由专门的基础设施、协调机构和资助者提供支持。
