PhD defence F.C.W. (Frédérique) van Krugten

Dissertation in short:

In light of the high prevalence and associated burden of mental health problems, national health systems strive to deliver accessible, efficient and high-quality mental healthcare. As resources in healthcare are limited, they need to be used in such a way that they yield most (health) benefits. Ensuring this is challenging and relates to both the organization of (mental) healthcare and the type of interventions offered in the mental healthcare system. This thesis addressed both issues by developing instruments that have the potential to enhance the (evaluation of the) efficiency of mental healthcare.

Within this thesis so-called "Decision Tools" have been developed that could facilitate the systematic and standardized early identification of patients in need of highly specialized mental healthcare. In addition, the Mental Health Quality of Life questionnaire has been developed and showed a promising capability as a feasible and psychometrically sound measure to assess quality of life in people with mental health problems. With the obtained preference-based value set, the MHQoL can be used to evaluate whether the quality of life of patients in need of highly specialized care indeed benefits from early referral and access to more tailored treatment pathways, but also to assess the (cost-)effectiveness of mental health interventions more broadly. The results of this thesis thereby illustrate that psychometrically good instruments can be developed that have the potential to improve the (evaluation of the) (cost) effectiveness of mental health care. This benefits both mental healthcare patients and other users of the healthcare system in the Netherlands.